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适应不良应对方式对肺结核患者心理结局的影响

The Impact of Maladaptive Coping Styles on Psychological Outcomes in Tuberculosis Patients.

作者信息

Papava Ion, Daescu Ana-Maria Cristina, Dehelean Liana, Bredicean Ana-Cristina, Ilie Adrian Cosmin, Ursoniu Sorin, Bondrescu Mariana, Radu Ion, Daescu Andrei, Gaitoane Alexandru-Ioan, Oancea Cristian

机构信息

Neurosciences Department, Discipline of Psychiatry, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.

Center for Cognitive Research in Neuropsychiatric Pathology (NeuroPsy-Cog), "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.

出版信息

Healthcare (Basel). 2025 May 1;13(9):1042. doi: 10.3390/healthcare13091042.

Abstract

BACKGROUND/OBJECTIVE: Tuberculosis (TB) is associated with significant psychological distress, including anxiety and depression, which may be influenced by coping styles. This study aimed to evaluate the relationship between coping mechanisms, psychological outcomes, and sociodemographic factors in TB patients.

METHODS

A total of 100 TB patients admitted to the Victor Babeș Clinical Hospital of Infectious Diseases and Pneumophtisiology, Timișoara, were assessed using the COPE questionnaire for coping styles and the GAD7 and PHQ9 scales for anxiety and depression. The Wilcoxon signed-rank test analyzed the changes in the psychological scores between admission and discharge.

RESULTS

Multinomial and linear regression analyses identified the predictors of coping styles based on psychological and sociodemographic factors. Anxiety and depression significantly improved during hospitalization (PHQ9: < 0.001, GAD7: < 0.001). Social-support-focused coping showed the largest depression reduction (PHQ9: from 13 to 4), while avoidant coping had the lowest residual distress (PHQ9 = 0.5, GAD7 = 0). Age and marital status were significant predictors of problem-focused coping, with older and married patients being more likely to adopt this strategy (β = 0.08, = 0.008). Coping styles significantly influence psychological outcomes in TB patients. Problem-focused coping was associated with better psychological recovery, while social-support-focused coping was linked to persistent distress.

CONCLUSIONS

Integrating mental health screening into TB care and tailoring interventions to coping styles may enhance psychological resilience and potentially support treatment adherence, a relationship that should be further explored in future research.

摘要

背景/目的:结核病(TB)与严重的心理困扰有关,包括焦虑和抑郁,而应对方式可能会对其产生影响。本研究旨在评估结核病患者的应对机制、心理结果和社会人口学因素之间的关系。

方法

对蒂米什瓦拉维克托·巴比什传染病和肺病临床医院收治的100例结核病患者,使用应对方式的COPE问卷以及焦虑和抑郁的GAD7和PHQ9量表进行评估。采用Wilcoxon符号秩检验分析入院和出院时心理评分的变化。

结果

多项和线性回归分析确定了基于心理和社会人口学因素的应对方式预测因素。住院期间焦虑和抑郁显著改善(PHQ9:<0.001,GAD7:<0.001)。以社会支持为重点的应对方式使抑郁减轻幅度最大(PHQ9:从13降至4),而回避应对的残余困扰最低(PHQ9 = 0.5,GAD7 = 0)。年龄和婚姻状况是问题聚焦应对的重要预测因素,年龄较大和已婚的患者更有可能采用这种策略(β = 0.08, = 0.008)。应对方式显著影响结核病患者的心理结果。问题聚焦应对与更好的心理恢复相关,而以社会支持为重点的应对与持续困扰相关。

结论

将心理健康筛查纳入结核病护理,并根据应对方式调整干预措施,可能会增强心理复原力,并有可能支持治疗依从性,这种关系应在未来研究中进一步探索。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c0f/12071460/7ef6da68ff30/healthcare-13-01042-g001.jpg

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