Dowdy S W, Dwyer K A, Smith C A, Wallston K A
School of Nursing Vanderbilt University, Nashville, TN 37240, USA.
Arthritis Care Res. 1996 Dec;9(6):449-56. doi: 10.1002/art.1790090606.
This study examined the relationship of gender and psychological well-being (PWB) in community-dwelling persons with rheumatoid arthritis (RA).
Data from the first wave of two longitudinal panel studies of persons with RA were examined (93 men and 276 women in panel 1; 60 men and 147 women in panel 2). Subjects completed self-report questionnaires on behavioral aspects of RA. Psychological well-being was assessed in both panels by the Center for Epidemiologic Studies-Depression Scale, using its 4 subcomponents, including positive and negative affect. Panel 2 had additional measures of PWB, namely the Positive and Negative Affect Schedule and the Satisfaction With Life Scale. Potential explanatory variables were then examined in an attempt to account for the observed gender differences.
Gender differences were found for negative indicators of PWB, while positive indicators of PWB showed no significant differences by gender. As with other community samples, women reported higher levels of depressive symptoms and negative mood than men. Quality of emotional support, passive pain coping, and physical functional impairment could only partially explain the observed gender differences in this study.
The relationship of gender to negative indicators of PWB cannot easily be diminished or dismissed. The mechanisms by which gender differentially affects PWB need to be further explored in order to intervene appropriately to help men and women with RA achieve an optimal quality of life.
本研究探讨了社区类风湿关节炎(RA)患者的性别与心理健康(PWB)之间的关系。
对两项RA患者纵向面板研究第一波的数据进行了分析(面板1中有93名男性和276名女性;面板2中有60名男性和147名女性)。受试者完成了关于RA行为方面的自我报告问卷。两个面板均使用流行病学研究中心抑郁量表及其4个亚成分(包括积极和消极情绪)评估心理健康。面板2还采用了其他心理健康测量方法,即正负情绪量表和生活满意度量表。然后对潜在的解释变量进行了研究,试图解释观察到的性别差异。
在心理健康的负面指标上发现了性别差异,而心理健康的正面指标在性别上没有显著差异。与其他社区样本一样,女性报告的抑郁症状和负面情绪水平高于男性。情感支持质量、被动疼痛应对和身体功能损害只能部分解释本研究中观察到的性别差异。
性别与心理健康负面指标之间的关系不易被削弱或忽视。需要进一步探讨性别对心理健康产生不同影响的机制,以便进行适当干预,帮助患有RA的男性和女性实现最佳生活质量。