Devins G M, Stam H J, Koopmans J P
Clarke Institute of Psychiatry, University of Toronto, Ontario.
Can J Psychiatry. 1994 Dec;39(10):608-16. doi: 10.1177/070674379403901005.
In addition to prolonging life, successful treatment by laryngectomy also results in functional disability (loss of speech) and physical disfigurement (stoma). It was hypothesized that these after-effects contribute to perceived stigma which, in turn, compromises quality of life. The hypothesis that the psychosocial impact of perceived stigma operates through illness intrusiveness--illness-induced disruptions that interfere with continued involvements in valued activities and interests--was tested. Data were collected from 51 laryngectomy recipients via standardized interviews. As hypothesized, results indicated that: 1. both perceived stigma and illness intrusiveness are related to psychosocial well-being and emotional distress; 2. illness intrusiveness mediates the relation between perceived stigma and psychosocial outcomes; 3. the psychosocial impact of illness intrusiveness is most devastating in the context of highly stigmatized self-perception; and 4. unique profiles of illness intrusiveness across individual life domains may be associated with specific psychosocial outcomes. Findings are discussed in relation to the hypothesis that illness intrusiveness is a common underlying determinant of the psychosocial impact of chronic illness.
除了延长生命外,喉切除术的成功治疗还会导致功能残疾(言语丧失)和身体毁容(造口)。据推测,这些后遗症会导致感知到的耻辱感,进而损害生活质量。研究检验了这样一个假设:感知到的耻辱感对心理社会的影响是通过疾病侵扰起作用的,疾病侵扰是指疾病引起的干扰,妨碍人们继续参与有价值的活动和兴趣。通过标准化访谈从51名喉切除术受者那里收集了数据。正如所推测的那样,结果表明:1. 感知到的耻辱感和疾病侵扰都与心理社会幸福感和情绪困扰有关;2. 疾病侵扰在感知到的耻辱感和心理社会结果之间起中介作用;3. 在高度耻辱感的自我认知背景下,疾病侵扰对心理社会的影响最为严重;4. 各个生活领域中疾病侵扰的独特特征可能与特定的心理社会结果相关。研究结果围绕疾病侵扰是慢性病心理社会影响的一个常见潜在决定因素这一假设进行了讨论。