Kunzendorff E, Scholl U, Scholl M
Institut für Sozialhygiene-Lehrbereich Medizinische Psychologie und Medizinische Soziologie, Medizinische Hochschule Erfurt.
Rehabilitation (Stuttg). 1993 Aug;32(3):177-84.
The concept of adaptation and quality of life has gained central importance in the research on chronically ill patients and their rehabilitation. This contribution examines the impact of psychological and behavioural factors on the quality of life and coping processes in two groups of chronically ill patients (i.e., n = 48 myocardial infarction survivors, and n = 48 patients with liver diseases). Coping responses and quality of life were measured using Janke et al.'s stress coping questionnaire SVF (1985), while other variables (psychosocial stress and social support) were determined by a variety of self-report data, test measures (von Zerssen's emotional state scale, 1976), as well as interview data, with repeat data compilation after three years (longitudinal study). Significant differences were found for each of the patient groups. Effectiveness of coping appeared to be negatively linked with frequent use of "avoidance", "denial", and "resignation" in patients with psychosocial strain and lack of information. The choice of coping strategy seems to be multi-determined and is related to illness state and sex, with changes occurring over time. The knowledge of coping strategy preferences is highly relevant for the relationship between physician and patient as well as for the process of rehabilitation.
适应概念和生活质量在慢性病患者及其康复研究中已变得至关重要。本论文探讨了心理和行为因素对两组慢性病患者（即48名心肌梗死幸存者和48名肝病患者）生活质量和应对过程的影响。应对反应和生活质量通过扬克等人（1985年）的压力应对问卷SVF进行测量，而其他变量（心理社会压力和社会支持）则通过各种自我报告数据、测试量表（冯·泽尔森情绪状态量表，1976年）以及访谈数据来确定，并在三年后进行重复数据收集（纵向研究）。每个患者组都发现了显著差异。在存在心理社会压力和信息不足的患者中，应对的有效性似乎与频繁使用“回避”“否认”和“顺从”呈负相关。应对策略的选择似乎是多因素决定的，与疾病状态和性别有关，并且会随时间变化。了解应对策略偏好对于医患关系以及康复过程非常重要。
