Commonalities and Differences in Psychological Adjustment to Chronic Illnesses Among Older Adults: a Comparative Study Based on the Stress and Coping Paradigm.

BACKGROUND

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.

METHOD

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.

RESULTS

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).

CONCLUSION

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.