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区分并预测患者对慢性病适应情况的心理社会和临床因素。

Psychosocial and Clinical Factors That Differentiate and Predict Patients' Adaptation to Chronic Diseases.

作者信息

Laza Ruxandra, Al Ghazi Loredana, Lustrea Anca, Lazureanu Voichita Elena, Oancea Cristian Iulian, Luput-Andrica Ioana Melinda, Poplicean Emanuel Ionut, Ilina Razvan, Cireap Natalia, Bob Flaviu, Olariu Nicu, Ionita Ioana, Lazar Sandra, Dehelean Liana, Romosan Radu Stefan, Romosan Ana-Maria

机构信息

Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania.

Department of Educational Sciences, University Clinic of Therapies and Psycho-Pedagogical Counseling, West University of Timisoara, Timisoara, Romania.

出版信息

Patient Prefer Adherence. 2025 May 24;19:1539-1556. doi: 10.2147/PPA.S518080. eCollection 2025.

Abstract

PURPOSE

Adaptation to chronic disease is an important factor for the quality of life of patients and their families. This research aimed to identify the psychosocial and clinical factors that determine significant differences and best predict the patients' adaptation to chronic diseases. Understanding these factors enables the design of evidence-based preventive interventions that promote early adaptation.

PATIENTS AND METHODS

A quantitative, non-experimental comparative and predictive study design was conducted. Several clinical, demographic, and psychological factors were measured with an online questionnaire. This study was conducted on a convenience sample of 263 patients with chronic diseases: 63 (24%) had chronic kidney disease with dialysis dependency, 49 (18.6%) had solid neoplasms, 61 (23.2%) had hemopathies, 64 (24.3%) had HIV infection, and 26 (9.9%) had tuberculosis.

RESULTS

Adaptation to chronic disease varies based on the type of diagnosis, with lower adaptation seen in conditions that significantly impact daily life, involve comorbidities, and require frequent treatments, like chronic kidney disease. The most significant predictor of adaptation to the chronic disease is the female gender. Other predictive factors are medication adherence, social support, and self-efficacy in managing chronic disease. Patients without comorbidities and fewer medications are more prone to illness denial, alongside younger, urban, employed, and higher-educated patients, potentially neglecting treatment. Patients with comorbidities and the older patients require greater emotional support, with psychological counseling and support groups being beneficial.

CONCLUSION

Current data underlines the need for an individualized approach to chronic disease management, which should consider demographic and psychological factors in addition to clinical ones. It is important to design early interventions for the development of adaptation to chronic disease, which could include individual and family counseling and education programs for medication administration, treatment at home, adherence to a healthy lifestyle, and inclusion of the patient and his family in social support groups.

摘要

目的

适应慢性病是影响患者及其家庭生活质量的重要因素。本研究旨在确定那些导致显著差异并能最佳预测患者对慢性病适应情况的心理社会和临床因素。了解这些因素有助于设计出促进早期适应的循证预防性干预措施。

患者与方法

采用定量、非实验性比较和预测性研究设计。通过在线问卷对若干临床、人口统计学和心理因素进行测量。本研究以263例慢性病患者的便利样本为对象:63例(24%)患有依赖透析的慢性肾病,49例(18.6%)患有实体肿瘤,61例(23.2%)患有血液病,64例(24.3%)感染了艾滋病毒,26例(9.9%)患有结核病。

结果

对慢性病的适应情况因诊断类型而异,在那些对日常生活有重大影响、伴有合并症且需要频繁治疗的疾病(如慢性肾病)中,适应情况较差。适应慢性病的最显著预测因素是女性性别。其他预测因素包括药物依从性、社会支持以及慢性病管理中的自我效能感。没有合并症且用药较少的患者更容易否认患病,此外,年轻、居住在城市、有工作且受过高等教育的患者也可能忽视治疗。患有合并症的患者和老年患者需要更多情感支持,心理咨询和支持小组会有所帮助。

结论

当前数据强调了慢性病管理采用个体化方法的必要性,这种方法除临床因素外还应考虑人口统计学和心理因素。为促进对慢性病的适应而设计早期干预措施很重要,这些措施可包括针对药物管理、居家治疗、坚持健康生活方式的个体及家庭咨询和教育项目,以及让患者及其家人加入社会支持小组。

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