Levine J, Warrenburg S, Kerns R, Schwartz G, Delaney R, Fontana A, Gradman A, Smith S, Allen S, Cascione R
Psychosom Med. 1987 Mar-Apr;49(2):109-17. doi: 10.1097/00006842-198703000-00001.
This longitudinal study investigated the relationship between denial of illness and the course of recovery in patients with coronary heart disease. Using a newly developed interview instrument, the Levine Denial of Illness Scale (LDIS), the level and modes of denial were assessed in 45 male patients who were hospitalized for myocardial infarction or for coronary bypass surgery, of whom 30 were followed for 1 year after discharge. The reliability, internal consistency, and validity of the LDIS were found to be satisfactory. Furthermore, the LDIS showed discriminant validity from trait measures of denial. LDIS scores were not associated with severity of illness or risk factors. High deniers spent fewer days in intensive care and had fewer signs of cardiac dysfunction during their hospitalization relative to low deniers. However, in the year following discharge, high deniers adapted more poorly than low deniers: high deniers were more noncompliant with medical recommendations and required more days of rehospitalization. The findings suggest that denial of illness is adaptive during acute hospital recovery, but is maladaptive in the long-run after hospital discharge.
这项纵向研究调查了冠心病患者对疾病的否认与康复过程之间的关系。使用一种新开发的访谈工具——莱文疾病否认量表（LDIS），对45名因心肌梗死或冠状动脉搭桥手术住院的男性患者的否认程度和方式进行了评估，其中30名患者在出院后随访了1年。结果发现LDIS的信度、内部一致性和效度均令人满意。此外，LDIS与否认的特质测量方法相比具有区分效度。LDIS得分与疾病严重程度或风险因素无关。与低否认者相比，高否认者在重症监护室的天数更少，住院期间心脏功能障碍的迹象也更少。然而，在出院后的一年里，高否认者的适应情况比低否认者更差：高否认者更不遵守医疗建议，需要更多的再次住院天数。研究结果表明，对疾病的否认在急性住院康复期间具有适应性，但在出院后的长期过程中则具有不良适应性。
