PhD candidate, School of Nursing and Midwifery, the University of Newcastle, Callaghan, Australia; Lecturer, Department of Nursing, Bengbu Medical College, Bengbu, China.
Head nurse, Department of Nursing, the First Affiliated Hospital of Bengbu Medical College, Bengbu, China.
J Nurs Scholarsh. 2020 Mar;52(2):145-154. doi: 10.1111/jnu.12540. Epub 2020 Feb 3.
To determine whether illness perceptions, coping strategies, and sociodemographic and clinical variables are related to the quality of life (QoL) in adults with multiple chronic conditions (MCCs) living in China.
By employing a cross-sectional design based on the transactional stress and coping theory, a convenience sample of adults with MCCs were recruited from a university-affiliated hospital between November 2017 and May 2018 in Northern Anhui, China.
A self-reported questionnaire, including the Brief Illness Perceptions Questionnaire, the Brief Coping Orientation to Problems Experienced inventory, and the Short Form Survey version 2, was administered. Sociodemographic and clinical data regarding MCCs were also collected. Descriptive statistics including frequencies, means, standard deviations, and correlation coefficients were calculated to examine the relationship between illness perceptions, coping, and QoL. Hierarchical multiple regression models were used to identify variables associated with physical and mental QoL.
A total of 351 participants (50% male) were recruited, with a mean age of 58.9 years (SD = 14.6). Of the participants, 83% had two chronic conditions. Participants reported impaired physical and mental QoL when compared with the general population in China. Poorer QoL was correlated with stronger illness perceptions of consequences and timeline and increased use of denial and disengagement and self-blame. Increasing age and more chronic conditions were associated with worse QoL. A higher education level was significantly associated with better physical and mental QoL.
This study found that adults with MCCs living in China experienced impaired QoL. The strong relationship found between the participants' perceptions of MCCs, coping strategies, and QoL suggested that healthcare professionals should recognize the physical and psychological impacts of MCCs and address the significance of adaptations to MCCs in future treatment programs. The findings will help healthcare professionals design more specific interventions to modify illness perceptions and enhance certain coping strategies to improve the QoL of people with MCCs. Healthcare professionals can mobilize available resources from healthcare and social systems to enhance people's coping and adaptation to MCCs.
With an understanding of the illness perceptions of people with MCCs, healthcare professionals could offer information related to consequences, timeline, and personal control to enable better alignment between people's expectations and their actual situations. By knowing people's coping strategies, healthcare professionals can offer additional support to people who prefer strategies of denial and disengagement and self-blame.
确定在中国患有多种慢性疾病 (MCC) 的成年人的疾病感知、应对策略以及社会人口学和临床变量与生活质量 (QoL) 的相关性。
基于交易压力和应对理论，采用横断面设计，于 2017 年 11 月至 2018 年 5 月在安徽省北部的一所大学附属医院招募 MCC 成年患者作为便利样本。
采用自我报告问卷，包括简明疾病感知问卷、简明问题应对取向量表和简短形式健康调查量表 2 版，收集社会人口学和 MCC 相关临床数据。采用频数、均数、标准差和相关系数等描述性统计方法，以检验疾病感知、应对与 QoL 之间的关系。采用分层多元回归模型，以确定与生理和心理 QoL 相关的变量。
共招募 351 名参与者（50%为男性），平均年龄为 58.9 岁（SD=14.6）。其中 83%的参与者患有两种慢性疾病。与中国一般人群相比，参与者报告的生理和心理 QoL 受损。较差的 QoL 与疾病后果和时间进程感知更强、否认和回避、自责应对方式使用增加相关。年龄增长和慢性疾病增多与 QoL 更差相关。较高的教育水平与较好的生理和心理 QoL 显著相关。
本研究发现，中国 MCC 成年患者的 QoL 受损。参与者对 MCC 的感知、应对策略与 QoL 之间的强相关性表明，医护人员应认识到 MCC 对患者身心的影响，并在未来的治疗计划中解决对 MCC 的适应问题。研究结果将有助于医护人员设计更具体的干预措施，以改变疾病感知，增强某些应对策略，从而提高 MCC 患者的 QoL。医护人员可以调动医疗和社会系统中的现有资源，以增强人们对 MCC 的应对和适应能力。
了解 MCC 患者的疾病感知，医护人员可以提供与后果、时间进程和个人控制相关的信息，以更好地使患者的期望与实际情况相匹配。通过了解患者的应对策略，医护人员可以为偏好否认和回避、自责应对方式的患者提供额外的支持。
