评估和应对在脊髓损伤或获得性脑损伤患者的重要他人的韧性和痛苦之间起中介作用：一项横断面研究。
Appraisals and coping mediate the relationship between resilience and distress among significant others of persons with spinal cord injury or acquired brain injury: a cross-sectional study.
机构信息
Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.
Sint Maartenskliniek, Department of Rehabilitation, Nijmegen, the Netherlands.
出版信息
BMC Psychol. 2020 May 20;8(1):51. doi: 10.1186/s40359-020-00419-z.
BACKGROUND
Many significant others of persons with serious conditions like spinal cord injury (SCI) and acquired brain injury (ABI) report high levels of psychological distress. In line with the stress-coping model, the aim of the present study was to investigate the relationship between personal resource resilience and psychological distress, and whether appraisals of threat and loss, and passive coping mediate this relationship.
METHODS
Significant others (n = 228) of persons with SCI or ABI completed questionnaires shortly after admission to first inpatient rehabilitation after onset of the condition. The questionnaire included measures to assess psychological distress (Hospital Anxiety and Depression Scale), resilience (Connor-Davidson Resilience Scale-10), appraisals (Appraisals of Life Events scale, threat and loss) and passive coping (Utrecht Coping List). The PROCESS tool was used to test the presence of mediation. Confounding and differences between SCI and ABI were investigated.
RESULTS
High levels of psychological distress among significant others were found (34-41%). Fifty-five percent of the variance in psychological distress was explained by the relationship between resilience and psychological distress. This relationship was mediated by appraisals of threat and loss, and passive coping. The relationship between resilience and psychological distress was similar in the SCI and ABI groups.
CONCLUSIONS
The results of our study indicate that appraisals of threat and loss and passive coping are mediating factors in the relationship between resilience and psychological distress. It seems useful to investigate if interventions focussing on psychological factors like resilience, appraisal and coping are effective to prevent or reduce psychological distress among significant others of persons with SCI or ABI.
TRIAL REGISTRATION
Dutch trial register NTR5742. Registered January 9, 2016.
背景
许多患有严重疾病（如脊髓损伤[SCI]和获得性脑损伤[ABI]）的人的重要他人报告存在较高水平的心理困扰。根据压力应对模型，本研究旨在调查个人资源韧性与心理困扰之间的关系，以及威胁和丧失的评估以及被动应对是否会调解这种关系。
方法
SCI 或 ABI 患者的重要他人（n=228）在发病后首次入住住院康复机构时不久完成了问卷。问卷包括评估心理困扰（医院焦虑和抑郁量表）、韧性（Connor-Davidson 韧性量表-10）、评估（生活事件评估量表、威胁和丧失）和被动应对（乌得勒支应对清单）的措施。使用 PROCESS 工具来检验是否存在中介作用。研究了混杂因素和 SCI 与 ABI 之间的差异。
结果
重要他人的心理困扰水平较高（34-41%）。韧性与心理困扰之间的关系解释了心理困扰的 55%的方差。这种关系通过威胁和丧失的评估以及被动应对来调解。在 SCI 和 ABI 组中，韧性和心理困扰之间的关系相似。
结论
我们的研究结果表明，威胁和丧失的评估以及被动应对是韧性和心理困扰之间关系的中介因素。研究关注韧性、评估和应对等心理因素的干预措施是否能有效预防或减少 SCI 或 ABI 患者的重要他人的心理困扰似乎是有用的。
试验注册
荷兰试验注册 NTR5742。于 2016 年 1 月 9 日注册。
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