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在患有慢性疾病的老年人中,较高的应对自我效能与较低的虚弱前期/虚弱几率相关。

High coping self-efficacy associated with lower odds of pre-frailty/frailty in older adults with chronic disease.

作者信息

Hladek Melissa D, Gill Jessica, Bandeen-Roche Karen, Walston Jeremy, Allen Jerilyn, Hinkle Janice L, Lorig Kate, Szanton Sarah L

机构信息

School of Nursing, Johns Hopkins University, Baltimore, MD, USA.

Tissue Injury Branch, NIH, NINR, Bethesda, MD, USA.

出版信息

Aging Ment Health. 2020 Dec;24(12):1956-1962. doi: 10.1080/13607863.2019.1639136. Epub 2019 Jul 10.

Abstract

OBJECTIVES

Frailty affects an estimated 15% of community dwelling older adults. Few studies look at psychosocial variables like self-efficacy (confidence to perform well at a particular task or life domain) in relation to frailty. The purpose of this study was to evaluate associations between pre-frailty/frailty and self-efficacy.

METHODS

This cross-sectional study enrolled community dwelling older adults 65 and older ( = 146) with at least one chronic condition. Scales included: 5-item FRAIL scale (including measures of Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight); coping self-efficacy used to measure confidence in one's ability to problem solve, emotionally regulate and ask for support when problems in life occur; illness intrusiveness; patient health questionnaire to assess depressive symptoms; financial strain; life events count; social support; heart rate; tobacco use and body mass index. Logistic regression was used for model development.

RESULTS

Roughly half (49.3%) of the participants were frail/pre-frail. High coping self-efficacy was associated with a 92% decreased odds of pre-frailty/frailty after adjustment for age, sex, race, co-morbidities, heart rate, a life events count, and body mass index. This relationship remained significant when illness intrusiveness and depression scores were added to the model (OR: 0.10; -value = 0.014). Increases in age, co-morbidities, heart rate and body mass index were also significantly associated with higher adjusted odds of pre-frailty/frailty.

CONCLUSIONS

High coping self-efficacy was associated with greater odds of a robust state. Further consideration should be given to coping self-efficacy in frailty research and intervention development.

摘要

目的

据估计,虚弱影响着15%的社区老年居民。很少有研究探讨诸如自我效能感(在特定任务或生活领域表现出色的信心)等心理社会变量与虚弱之间的关系。本研究的目的是评估虚弱前期/虚弱与自我效能感之间的关联。

方法

这项横断面研究纳入了65岁及以上(n = 146)患有至少一种慢性病的社区老年居民。所使用的量表包括:5项虚弱量表(包括疲劳、耐力、步行、疾病和体重减轻的测量);应对自我效能感,用于衡量一个人在生活中出现问题时解决问题、情绪调节和寻求支持的能力;疾病侵扰性;用于评估抑郁症状的患者健康问卷;经济压力;生活事件计数;社会支持;心率;吸烟情况和体重指数。采用逻辑回归进行模型构建。

结果

大约一半(49.3%)的参与者处于虚弱前期/虚弱状态。在对年龄、性别、种族、合并症、心率、生活事件计数和体重指数进行调整后,高应对自我效能感与虚弱前期/虚弱几率降低92%相关。当将疾病侵扰性和抑郁评分纳入模型时,这种关系仍然显著(OR:0.10;P值 = 0.014)。年龄、合并症、心率和体重指数的增加也与虚弱前期/虚弱的调整后几率升高显著相关。

结论

高应对自我效能感与更强壮状态的几率更高相关。在虚弱研究和干预开发中应进一步考虑应对自我效能感。

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