Heim E, Augustiny K F, Schaffner L, Valach L
Psychiatrische Universitätspoliklinik, Bern, Switzerland.
J Psychosom Res. 1993 Jul;37(5):523-42. doi: 10.1016/0022-3999(93)90008-4.
This study examines the variability and stability of coping in cancer subjects over time and situation. In a prospective longitudinal design 74 breastcancer patients have been followed for 3-5 yr at 3-6 monthly intervals. A variety of measures related to coping and adjustment were taken. This report limits itself to the findings of an instrument developed for this study, the Bernese Coping Modes in which 26 coping modes were rated by observers. Results confirm arguments in favour of both variability and stability in coping activity over time and situation. Two measures support stability: rank values and a multivariate measure (MDS) with three constant dimensions: (1) support and acceptance; (2) denial; (3) diversion by thought and action. Evidence for variability is: the potential range of coping modes and a large variety of additional modes at most observation times. Subsequently time measures of coping were attributed to eight predefined illness stages as distinct clinical situations. Thus variability or richness of coping further increased. The implications of these findings for measurement in coping research are discussed.
本研究考察了癌症患者应对方式随时间和情境的变异性与稳定性。采用前瞻性纵向设计，对74例乳腺癌患者进行了为期3至5年的随访，随访间隔为3至6个月。采取了多种与应对和适应相关的测量方法。本报告仅限于该研究开发的一种工具的研究结果，即伯尔尼应对方式，观察者对其中26种应对方式进行了评分。结果证实了应对活动随时间和情境存在变异性与稳定性的观点。有两项测量指标支持稳定性：排名值和一个具有三个恒定维度的多变量测量指标（MDS）：（1）支持与接纳；（2）否认；（3）通过思维和行动转移注意力。变异性的证据是：应对方式的潜在范围以及在大多数观察时间出现的大量其他方式。随后，将应对的时间测量指标归因于八个预先定义的疾病阶段，作为不同的临床情境。因此，应对的变异性或丰富性进一步增加。讨论了这些发现对应对研究测量的意义。
