Laboratory of Nursing Theory and Fundamentals, Institute of Nursing and Midwifey, Faculty of Health Sciences, Jagiellonian University Medical College, Michałowskiego 12 Street, 31-126, Krakow, Poland.
Laboratory for Research On Aging Society, Department of Sociology of Medicine, The Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland.
Rheumatol Int. 2023 Sep;43(9):1665-1674. doi: 10.1007/s00296-023-05367-6. Epub 2023 Jun 18.
Coping with a chronic disease such as rheumatoid arthritis (RA) involves significant changes in life and promotes stressful situations. The inability to cope with stress can contribute to the lack of effectiveness of therapy. The aim of this study was to evaluate the relationship between perceived stress, coping strategies, and the clinical status of RA patients determined by C-reactive protein (CRP) and Disease Activity Score (DAS28). 165 subjects were studied, 84 of them had RA and the rest were controls. Standardised questionnaires were used: the Inventory for the Measurement of Coping Strategies (Mini-COPE) and the Perceived Stress Scale (PSS-10). A self-administered questionnaire was used to collect sociodemographic data. The blood levels of protein CRP and cortisol were determined. DAS28 was obtained from medical records. The study was cross-sectional. The mean severity of perceived stress PSS-10 was not significantly different between the control and study groups. RA patients most often used coping strategies such as active coping, planning, and acceptance. Compared to the control group, they used the strategy of turning to religion significantly more often (1.8 vs 1.4; p = 0.012). Women with RA who had higher cortisol levels were more likely to use positive reevaluation, seeking emotional support and instrumental support, as well as the denial strategy. In men with RA, high stress was associated with twice as high CRP levels compared to patients with low stress (p = 0.038). As the levels of CRP protein levels (p = 0.009) and the DAS28 index (p = 0.005) increased, patients were more likely to use a denial strategy.
应对类风湿性关节炎（RA）等慢性疾病会导致生活发生重大变化，并引发紧张局势。无法应对压力会导致治疗效果不佳。本研究旨在评估 RA 患者的感知压力、应对策略与 C 反应蛋白（CRP）和疾病活动评分（DAS28）所确定的临床状况之间的关系。共研究了 165 名受试者，其中 84 名患有 RA，其余为对照组。使用了标准化问卷：应对策略测量量表（Mini-COPE）和感知压力量表（PSS-10）。使用自我管理问卷收集社会人口统计学数据。测定了 CRP 和皮质醇的血液水平。从病历中获取 DAS28。该研究为横断面研究。控制组和研究组之间的 PSS-10 感知压力量表的平均严重程度无显著差异。RA 患者最常使用积极应对、计划和接受等应对策略。与对照组相比，他们更频繁地使用求助于宗教的策略（1.8 比 1.4；p=0.012）。皮质醇水平较高的 RA 女性更有可能使用积极重新评估、寻求情感支持和工具支持以及否认策略。在 RA 男性中，与低压力患者相比，高压力患者的 CRP 水平高出两倍（p=0.038）。随着 CRP 蛋白水平（p=0.009）和 DAS28 指数（p=0.005）的升高，患者更有可能使用否认策略。
