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老年人的应对灵活性与健康相关生活质量:共同反刍的补偿效应

Coping Flexibility and Health-Related Quality of Life Among Older Adults: The Compensatory Effect of Co-rumination.

作者信息

Kroemeke Aleksandra

机构信息

Department of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland.

出版信息

Front Psychol. 2019 Jan 23;10:59. doi: 10.3389/fpsyg.2019.00059. eCollection 2019.

Abstract

Coping flexibility, defined as a wide range of coping strategies, may be a promising construct in determining coping effectiveness, especially in conjunction with a person-centered approach. However, no studies have focused on these issues. The study aimed to identify the distinct, multidimensional patterns of strategies for coping with chronic health conditions and their association with changes in physical and psychological health-related quality of life (HRQoL) among older adults over a one month period. Coping strategies (brooding, reflection, co-rumination, and positive reappraisal) and HRQoL psychological and physical domains were assessed twice (at the baseline and one month later) among 210 older adults (age 76.12 ± 9.09 years, 66% women). The parallel process analysis demonstrated the sample heterogeneity regarding coping. In multidimensional latent class growth analysis (MLCGA), four coping classes of overall strategies were identified: consistently low (46%), medium and decreasing (18%), medium and increasing (20%), and consistently high (16%). The last two can be considered the coping flexibility. Participants in the medium and increasing subgroup reported enhancement in HRQoL psychological domain, whereas members of the consistently high subgroup indicated its decrease. The favorable effects were related to an increase in co-rumination. The findings shed light on the longitudinal patterns of coping in older adults, showing that coping flexibility is more adaptive when it relies on modifying coping efforts rather than coping complexity. Co-rumination played a key role, compensated by the effect of maladaptive strategies.

摘要

应对灵活性被定义为广泛的应对策略,在确定应对效果方面可能是一个有前景的概念,特别是与以人为主的方法相结合时。然而,尚无研究关注这些问题。本研究旨在确定老年人在一个月时间内应对慢性健康状况的不同多维策略模式及其与身心健康相关生活质量(HRQoL)变化的关联。在210名老年人(年龄76.12±9.09岁,66%为女性)中,对应对策略(沉思、反思、共同反刍和积极重新评价)以及HRQoL的心理和身体领域进行了两次评估(基线时和一个月后)。平行过程分析表明样本在应对方面存在异质性。在多维潜在类别增长分析(MLCGA)中,确定了总体策略的四个应对类别:持续低水平(46%)、中等且下降(18%)、中等且上升(20%)和持续高水平(16%)。最后两类可被视为应对灵活性。中等且上升亚组的参与者报告HRQoL心理领域有所改善,而持续高水平亚组的成员则表示该领域有所下降。积极影响与共同反刍的增加有关。这些发现揭示了老年人应对的纵向模式,表明当应对灵活性依赖于调整应对努力而非应对复杂性时,它更具适应性。共同反刍起到了关键作用,并由适应不良策略的影响进行补偿。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c46/6351461/defb52d6d0c3/fpsyg-10-00059-g001.jpg

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