Beckham J C, Burker E J, Rice J R, Talton S L
Veterans Administration Medical Center, Duke University Medical Center, Psychology Division, Durham, North Carolina, USA.
Behav Med. 1995 Winter;20(4):171-8. doi: 10.1080/08964289.1995.9933734.
The authors of the present study investigated the relationship between rheumatoid arthritis (RA) patients' demographic, medical, and functional status and caregivers' burden, optimism, and pessimism. Subjects were 65 RA patients and their caregivers who were recruited from an outpatient rheumatology clinic. Each caregiver completed the Burden Interview to measure caregiver burden and the Life Orientation Test to measure optimism and pessimism. Each RA patient completed the Arthritis Impact Measurement Scale to measure pain and physical disability as well as a number of cognitive measures to assess two summary psychological cognitive factors labeled self-efficacy expectations and distorted cognitions. These cognitive factors were based on the following commonly used measures in RA research: the Cognitive Errors Questionnaire, the Arthritis Self-Efficacy Scale, the Coping Strategies Questionnaire, and the Pain Beliefs and Perceptions Inventory. Correlational analyses indicated that patients' functional and psychological measures (including poor self-efficacy expectations regarding symptoms) were related to caregiver burden, that patient self-efficacy expectations were related to caregiver optimism, and that patient physical disability was related to caregiver pessimism. Regression analyses revealed that, when competing with other demographic and disease severity variables, the relationships between patient self-efficacy expectations and caregiver burden and caregiver optimism, and patient physical function and caregiver pessimism remained significant. Taken together, these findings suggest that patient expectancies about control over arthritis-related symptoms (including pain) are strongly related to caregiver burden and caregiver optimism and that patient physical status is strongly related to caregiver pessimism.
本研究的作者调查了类风湿性关节炎(RA)患者的人口统计学、医疗和功能状况与照料者的负担、乐观情绪和悲观情绪之间的关系。研究对象为65名RA患者及其照料者,他们是从一家门诊风湿病诊所招募而来的。每位照料者完成了用于测量照料者负担的《负担访谈》以及用于测量乐观情绪和悲观情绪的《生活取向测试》。每位RA患者完成了用于测量疼痛和身体残疾的《关节炎影响测量量表》以及一些认知测量,以评估两个概括性心理认知因素,即自我效能期望和认知扭曲。这些认知因素基于RA研究中常用的以下测量方法:《认知错误问卷》《关节炎自我效能量表》《应对策略问卷》以及《疼痛信念和认知量表》。相关性分析表明,患者的功能和心理测量指标(包括对症状的自我效能期望较低)与照料者负担相关,患者的自我效能期望与照料者的乐观情绪相关,患者的身体残疾与照料者的悲观情绪相关。回归分析显示,在与其他人口统计学和疾病严重程度变量进行竞争时,患者的自我效能期望与照料者负担和照料者乐观情绪之间的关系,以及患者的身体功能与照料者悲观情绪之间的关系仍然显著。综上所述,这些发现表明,患者对控制关节炎相关症状(包括疼痛)的期望与照料者负担和照料者乐观情绪密切相关,患者的身体状况与照料者悲观情绪密切相关。