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多发性硬化症患者的压力水平与应对策略及其与疾病进程的关系

The Level of Stress and Coping Strategies in Patients with Multiple Sclerosis and Their Relationships with the Disease Course.

作者信息

Kotas Roman, Nowakowska-Kotas Marta, Budrewicz Sławomir, Pokryszko-Dragan Anna

机构信息

Department of Psychiatry, Regional Specialist Hospital, ul. Iwaszkiewicza 5, 59-220 Legnica, Poland.

Department of Neurology, Wroclaw Medical University, ul. Borowska 213, 50-556 Wrocław, Poland.

出版信息

J Clin Med. 2021 Aug 30;10(17):3916. doi: 10.3390/jcm10173916.

Abstract

OBJECTIVES

Stress is supposed to be linked with a background of multiple sclerosis (MS) and the disease course.

DESIGN

The study aimed to assess the level of stress and coping strategies in MS patients within a year of follow-up and to investigate the relationships between these aspects and factors related-or not-to MS.

METHODS

In 65 patients with MS, the Perceived Stress Scale (PSS-10), Type D Scale (DS14) and Coping Orientations to Problems Experienced (COPE) were performed at baseline and after a year. Baseline PSS-10, DS-14 and COPE scores were analyzed with regard to demographics, MS duration, treatment, indices of disability and self-reported stressful events (SEs). Final PSS-10 and COPE results were analyzed with reference to MS activity and SE within a year of follow-up.

RESULTS

Initially, 67% of patients reported a moderate or high level of stress and 31% met Type-D personality criteria. Diverse coping strategies were preferred, most of which were problem-focused. The negative affectivity DS-14 subscore (NEG) was correlated with disability level. Non-health-related SEs were associated with higher PSS-10 and NEG scores. After a year, the mean PSS-10 score decreased, while COPE results did not change significantly. Non-health-related SEs were associated with a higher PSS-10 score and less frequent use of acceptance and humor strategies. Those with an active vs. stable MS course during the follow-up did not differ in terms of PSS-10 and COPE results.

CONCLUSIONS

MS patients experienced an increased level of stress. No significant relationships were found between stress or coping and MS course within a year. Non-health-related factors affected measures of stress more than MS-related factors.

摘要

目的

压力被认为与多发性硬化症(MS)背景及疾病进程有关。

设计

本研究旨在评估MS患者在随访一年内的压力水平及应对策略,并调查这些方面与MS相关或不相关因素之间的关系。

方法

对65例MS患者在基线期和一年后进行感知压力量表(PSS - 10)、D型量表(DS14)和应对问题经验取向量表(COPE)评估。分析基线期PSS - 10、DS - 14和COPE评分与人口统计学特征、MS病程、治疗、残疾指数及自我报告的应激事件(SEs)之间的关系。参照随访一年内的MS活动和SE分析最终的PSS - 10和COPE结果。

结果

最初,67%的患者报告有中度或高度压力,31%符合D型人格标准。患者偏好多种应对策略,其中大多数是以问题为导向的。消极情感性DS - 14子量表(NEG)得分与残疾水平相关。与健康无关的SEs与较高的PSS - 10和NEG得分相关。一年后,PSS - 10平均得分下降,而COPE结果无显著变化。与健康无关的SEs与较高的PSS - 10得分及较少使用接受和幽默策略相关。随访期间MS病程为活动期与稳定期的患者在PSS - 10和COPE结果方面无差异。

结论

MS患者经历了较高水平的压力。一年内压力或应对与MS病程之间未发现显著关系。与健康无关的因素比与MS相关的因素对压力测量的影响更大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8501/8432053/38b991548024/jcm-10-03916-g001.jpg

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