Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany.
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Int J Methods Psychiatr Res. 2021 Mar;30(1):e1854. doi: 10.1002/mpr.1854. Epub 2020 Sep 12.
Psychiatric patients are regularly informed about diagnoses. Treatment guidelines assume that informing patients fosters functional coping processes, but few research exists on how patients respond. Thus, the objective was to develop a standardized self-report measure to assess patients reactions to diagnoses.
Fifty nine items were generated based on a qualitative study. The process of item selection and determination of the factor structure were performed on a sample of 252 patients: Results of an explorative factor analysis with a randomly split sub-sample 1 were cross-validated by confirmatory factor analysis on sub-sample 2. The revised 26-item instrument was revaluated using data from an independent sample of 1.271 patients with different diagnoses.
Three functional and three dysfunctional processing styles emerged from the analyses and provided good model fit in the revaluation study (TLI = 0.935; CFI = 0.943; RMSEA = 0.051; SRMR = 0.048). Variance-analytical calculations and post hoc analyses revealed significant differences among diagnoses with regard to coping styles, such as schizophrenia was associated with self-stigmatization and anorexia nervosa showed pronounced over-identification. Overall, various diagnosis-dependent specifics were found.
As patients reactions to diagnoses vary substantially, their formation, impact on treatment and overall cause should be investigated in further studies.
精神科患者经常被告知诊断结果。治疗指南假设告知患者可以促进功能应对过程，但关于患者的反应的研究很少。因此，本研究的目的是开发一种标准化的自我报告量表来评估患者对诊断的反应。
根据一项定性研究，共生成了 59 个项目。项目选择和因子结构确定的过程是在 252 名患者的样本上进行的：对随机分为两半的子样本 1 进行探索性因子分析的结果，通过对子样本 2 的验证性因子分析进行交叉验证。对经过修订的 26 项工具进行了重新评估，使用来自具有不同诊断的 1271 名独立患者的数据集。
从分析中得出了三种功能和三种功能失调的处理方式，并且在重新评估研究中提供了良好的模型拟合（TLI = 0.935；CFI = 0.943；RMSEA = 0.051；SRMR = 0.048）。方差分析计算和事后分析表明，不同诊断的应对方式存在显著差异，例如精神分裂症与自我污名化有关，而厌食症则表现出明显的过度认同。总体而言，发现了与诊断相关的各种特定问题。
由于患者对诊断的反应存在很大差异，应在进一步的研究中调查其形成、对治疗的影响和总体原因。
