Department of Rehabilitation Medicine.
Rehabil Psychol. 2019 Aug;64(3):288-297. doi: 10.1037/rep0000279. Epub 2019 Apr 29.
Decisional autonomy-or sense of one's ability to make independent choices about one's life-is especially relevant to individuals who may feel their autonomy is limited due to physical challenges. Past work has found associations between measures of autonomy and quality of life (QoL) in individuals with disability and in older adults. However, it is less clear how autonomy influences the impact of pain and fatigue severity on QoL, especially in adults aging with physical disability. This study examined the relationship of decisional autonomy to QoL and the extent to which autonomy moderates the association between symptom severity and QoL.
We used hierarchical linear regression models to examine the associations between autonomy, pain and fatigue, and quality of life in a sample of individuals with long-term disability. In 2 sets of models, we examined individuals reporting some level of fatigue ( = 1,060, = 62.66, = 11.88) and some level of pain ( = 964, = 62.79, = 11.69).
We found that decisional autonomy significantly predicted QoL over and above other measures related to social participation. Decisional autonomy also weakly moderated the associations between fatigue and QoL and the associations between pain and QoL.
The findings indicate that levels of decisional autonomy may be important to QoL in individuals aging with physical limitations. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
决策自主性——即个人对自己生活做出独立选择的能力——对于那些可能因身体挑战而感到自主性受限的个体尤为重要。过去的研究发现，残疾人和老年人的自主性衡量指标与生活质量（QoL）之间存在关联。然而，自主性如何影响疼痛和疲劳严重程度对 QoL 的影响尚不清楚，特别是在身体残疾的成年人中。本研究考察了决策自主性与 QoL 的关系，以及自主性在多大程度上调节了症状严重程度与 QoL 之间的关联。
我们使用分层线性回归模型，在一个长期残疾的个体样本中检验了自主性、疼痛和疲劳与生活质量之间的关联。在 2 组模型中，我们分别检查了报告存在一定程度疲劳（n=1060，M=62.66，SD=11.88）和一定程度疼痛（n=964，M=62.79，SD=11.69）的个体。
我们发现，决策自主性在预测 QoL 方面显著优于其他与社会参与相关的衡量指标。决策自主性也在一定程度上调节了疲劳与 QoL 之间以及疼痛与 QoL 之间的关联。
这些发现表明，在身体受限的个体中，决策自主性的水平可能对 QoL 很重要。
