应对机制减轻了 COVID-19 大流行期间风湿性疾病患者的心理压力。

Coping Mechanisms Mitigate Psychological Stress in Patients With Rheumatologic Diseases During the COVID-19 Pandemic.

机构信息

From the Department of Medicine, Weill Cornell Medical College.

Department of Orthopedic Surgery.

出版信息

J Clin Rheumatol. 2022 Mar 1;28(2):e449-e455. doi: 10.1097/RHU.0000000000001757.

DOI:10.1097/RHU.0000000000001757

PMID:34054073

Abstract

BACKGROUND

Coping with stress is part of self-managing systemic rheumatic diseases. Our objective was to assess stress and coping during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

During the pandemic in New York City, patients taking disease-modifying antirheumatic drugs answered open-ended questions about the pandemic's effects on daily life and their rheumatic condition. Themes of stress and coping were discerned from volunteered responses. Patients also completed the standard Generalized Anxiety Disorder (GAD-7) scale/PROMIS Anxiety surveys. Anxiety scores were independent variables in multivariable analyses with stress and coping themes as combined dependent variables.

RESULTS

Of the 112 patients interviewed (86% women; mean age, 50 years), 72 volunteered COVID-19-related stress on their rheumatic condition, home, work, and finances. Patients volunteering stress were younger, had disease longer, were taking more than 1 medication, had worse GAD-7 scores and a positive anxiety screen, and had worse PROMIS scores that were significantly worse than population norms (all comparisons, p ≤ 0.01; all variables remained associated in multivariable analyses). Fourty-one patients volunteered coping mechanisms including support from others, engaging in activities, and resilience already establish in dealing with rheumatic diseases. Of these, 18 volunteered both coping and stress and 23 volunteered coping and no stress. Patients in the latter (coping-only) group were more likely to be older, taking only 1 medication, and had better GAD-7 and PROMIS scores (all comparisons, p ≤ 0.02). In multivariable analysis, older age (p = 0.02) and lower GAD-7 (p = 0.03) or PROMIS scores (p = 0.03) remained associated.

CONCLUSIONS

Patients reported stress and coping due to the COVID-19 pandemic. Analyses with standard anxiety measures demonstrated lower anxiety in patients who volunteered coping mechanisms.

摘要

背景

应对压力是自我管理系统性风湿病的一部分。我们的目的是评估 2019 年冠状病毒病（COVID-19）大流行期间的压力和应对方式。

方法

在纽约市大流行期间，服用疾病修饰抗风湿药物的患者回答了有关大流行对日常生活和风湿状况影响的开放式问题。从自愿回复中辨别出压力和应对主题。患者还完成了标准的广泛性焦虑症（GAD-7）量表/PROMIS 焦虑调查。焦虑评分是多变量分析中压力和应对主题作为综合因变量的自变量。

结果

在接受采访的 112 名患者中（86%为女性；平均年龄 50 岁），72 名患者自愿报告了 COVID-19 对其风湿状况、家庭、工作和财务的影响。自愿报告压力的患者年龄较小，患病时间较长，服用的药物超过 1 种，GAD-7 评分和焦虑筛查阳性，PROMIS 评分明显较差，明显低于人群正常值（所有比较，p≤0.01；所有变量在多变量分析中仍然相关）。41 名患者自愿报告了应对机制，包括他人的支持、参与活动和处理风湿疾病时已经建立的韧性。其中，18 名患者既自愿报告了应对方式又报告了压力，23 名患者仅报告了应对方式而没有报告压力。在后一组（仅应对）患者中，年龄较大（p=0.02）、服用的药物种类较少（p=0.02），GAD-7 和 PROMIS 评分也较好（所有比较，p≤0.02）。多变量分析显示，年龄较大（p=0.02）和 GAD-7 评分较低（p=0.03）或 PROMIS 评分较低（p=0.03）与压力有关。