Shao Jingjin, Yang Hang, Zhang Qinghua, Du Weiping, Lei Huijie
Centre for Mental Health Education, Faculty of Psychology, Southwest University, Beibei, Chongqing, 400715, China.
Department of Tourism and Art for Humanity, Chongqing Youth Vocational & Technical College, Chongqing, China.
Int J Behav Med. 2019 Apr;26(2):143-153. doi: 10.1007/s12529-019-09773-8.
This study aimed to validate the role of the stress and coping paradigm in the context of psychological adjustment to chronic illnesses among older adults by using the structural equation modeling technique, as well as investigating the differences in structural weights between older adults with arthritis and older adults with hypertension.
A cross-sectional study was conducted with 325 older adults with chronic illnesses (149 hypertension, 176 arthritis), aged 60-88 years, who completed questions on perceived social support, psychological resources, threat appraisal, self-efficacy, coping strategy, depressive symptoms, and anxiety.
The results revealed that older adults with arthritis experienced significantly higher anxiety (t = 2.91, p < 0.01) than those with hypertension, whereas no significant difference in their depressive symptoms was observed (t = 1.61, p > 0.05). Social support, psychological resources, threat appraisal, and self-efficacy had a significant direct relationship with psychological distress (β = - 0.15, β = - 0.38, β = 0.19, β = - 0.23, respectively). Multi-group analyses showed significant differences in structural weights between older adults with hypertension and those with arthritis (Δχ = 41.336, Δdf = 18, p < 0.01).
The stress and coping paradigm appears to be applicable for adjustment to chronic illnesses by allowing direct paths from social support, psychological resources, threat appraisal, and self-efficacy to psychological distress. The differences in structural weights may offer an intervening angle for clinical practitioners to design targeted interventions for older adults with different types of chronic illnesses.
本研究旨在运用结构方程建模技术验证压力与应对范式在老年人慢性疾病心理调适背景下的作用，并调查患有关节炎的老年人和患有高血压的老年人在结构权重上的差异。
对325名年龄在60 - 88岁的患有慢性疾病的老年人（149名高血压患者，176名关节炎患者）进行了横断面研究，这些老年人完成了关于感知到的社会支持、心理资源、威胁评估、自我效能感、应对策略、抑郁症状和焦虑的问卷调查。
结果显示，患有关节炎的老年人比患有高血压的老年人焦虑程度显著更高（t = 2.91，p < 0.01），而在抑郁症状方面未观察到显著差异（t = 1.61，p > 0.05）。社会支持、心理资源、威胁评估和自我效能感与心理困扰存在显著的直接关系（β分别为 - 0.15、 - 0.38、0.19、 - 0.23）。多组分析显示，患有高血压的老年人和患有关节炎的老年人在结构权重上存在显著差异（Δχ = 41.336，Δdf = 18，p < 0.01）。
压力与应对范式似乎适用于慢性疾病的调适，它允许从社会支持、心理资源、威胁评估和自我效能感直接通向心理困扰。结构权重的差异可能为临床医生为不同类型慢性疾病的老年人设计针对性干预措施提供一个干预角度。
