Wilcox V L, Kasl S V, Idler E L
Department of Epidemiology and Public Health, Yale University School of Medicine, USA.
J Gerontol B Psychol Sci Soc Sci. 1996 Mar;51(2):S96-104. doi: 10.1093/geronb/51b.2.s96.
This article describes change and stability in self-rated health after a major medical event. Using a prospective design, it examines the ability of premorbid and post-illness health perceptions to predict physical disability independently of medical, psychosocial, and behavioral variables. Participants (N=254) were a subsample of the New Haven cohort of the Established Populations for Epidemiologic Studies of the Elderly (EPESE) project who had survived hospitalization for stroke, myocardial infarction, or hip fracture. Data came from premorbid EPESE interviews, medical records, and interviews at 6 weeks and at 6 months after hospitalization. Health perceptions did not universally decline after the illness. Self-rated health at 6 weeks predicted disability at 6 months, but premorbid self-rated health did not, suggesting that illness-related changes in health perceptions influenced the recovery process. The effects of 6-week self-rated health on disability were independent of physical inactivity. The mechanisms by which health perceptions influence recovery are unclear.
本文描述了重大医疗事件后自评健康状况的变化与稳定性。采用前瞻性设计，研究病前和患病后的健康认知对身体残疾的预测能力，该预测独立于医疗、心理社会和行为变量。参与者（N = 254）是老年流行病学研究既定人群（EPESE）项目纽黑文队列的一个子样本，他们在中风、心肌梗死或髋部骨折住院治疗后存活下来。数据来自病前的EPESE访谈、病历以及住院后6周和6个月的访谈。患病后健康认知并非普遍下降。6周时的自评健康状况可预测6个月时的残疾情况，但病前自评健康状况则不能，这表明与疾病相关的健康认知变化影响了康复过程。6周时自评健康状况对残疾的影响独立于身体活动不足。健康认知影响康复的机制尚不清楚。
