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自我调节模型对理解类风湿关节炎患者健康相关生活质量的贡献。

Contribution of the self-regulation model to understanding the health related quality of life of rheumatoid arthritis patients.

机构信息

Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, 52900, Ramat-Gan, Israel.

出版信息

Qual Life Res. 2020 Feb;29(2):403-412. doi: 10.1007/s11136-019-02315-5. Epub 2019 Oct 1.

Abstract

PURPOSE

This study examined a comprehensive model that integrates the interrelationships among health-related-quality-of-life (HRQoL), disease duration, disease severity, illness representations, and coping resources regarding patients with Rheumatoid arthritis (RA), based on the Self-regulation model.

METHOD

A convenience sample of 164 patients with RA completed measures of disease's characteristics (disease duration, disease status), illness representations (timeline, consequences, self-control, treatment control, symptom burden, concern about RA, understanding RA, emotional representations), coping resources (resilience, social support), HRQoL, and socio-demographic questionnaires. The research model was assessed through path analysis.

RESULTS

Perceptions of higher treatment control, lower consequences of RA and lower symptom burden were directly related to HRQoL. The perceptions of higher self-control, higher treatment control, less concern about RA, and lower emotional representations were associated with higher resilience, which in turn was associated with higher HRQoL. The perceptions of higher treatment control, greater understanding of RA, and lower emotional representations were associated with higher perceived social support; however, social support was not associated with HRQoL.

CONCLUSIONS

This study contributes to a better understanding of the determinants of HRQoL among RA patients. The findings indicate that clinical interventions targeting RA patients' illness representations and resilience may assist patients with RA to improve their HRQoL.

摘要

目的

本研究基于自我调节模型,考察了一个综合模型,该模型整合了与类风湿关节炎(RA)患者的健康相关生活质量(HRQoL)、疾病持续时间、疾病严重程度、疾病认知和应对资源相关的相互关系。

方法

本研究采用便利抽样法,共纳入 164 例 RA 患者,对其进行疾病特征(疾病持续时间、疾病状况)、疾病认知(时间线、后果、自我控制、治疗控制、症状负担、对 RA 的担忧、对 RA 的理解、情绪认知)、应对资源(韧性、社会支持)、HRQoL 和社会人口学问卷的测量。通过路径分析评估研究模型。

结果

更高的治疗控制感、更低的 RA 后果和更低的症状负担与 HRQoL 直接相关。更高的自我控制感、更高的治疗控制感、对 RA 的担忧程度更低、情绪认知更低与更高的韧性有关,而韧性又与更高的 HRQoL 相关。更高的治疗控制感、对 RA 的理解程度更高、情绪认知更低与更高的感知社会支持有关;然而,社会支持与 HRQoL 无关。

结论

本研究有助于更好地理解 RA 患者 HRQoL 的决定因素。研究结果表明,针对 RA 患者疾病认知和韧性的临床干预措施可能有助于改善 RA 患者的 HRQoL。

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