Effects of coping on health outcome among women with gastrointestinal disorders
Effects of coping on health outcome among women with gastrointestinal disorders
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DOI：
10.1097/00006842-200005000-00004
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发表时间：
2000-05-01
影响因子：
3.3
通讯作者：
Toomey, TC
中科院分区：
文献类型：
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作者：
Drossman, DA;Leserman, J;Toomey, TC
背景：研究表明，应对的性质和质量可能会对健康结果产生积极或消极的影响；然而，在胃肠道疾病患者中，这种关系还没有得到很好的研究。目的：研究不同应对策略对胃肠道疾病女性健康结局的影响，以及这些应对策略如何改变教育、胃肠道疾病类型、神经质和虐待严重程度对健康结局的影响。方法：我们对转诊胃肠道诊所的174名患者进行了为期12个月的跟踪调查，以评估他们的健康状况，作为日常疼痛、床上残疾天数、心理困扰、日常功能障碍、看医生的次数、手术和手术次数的衍生变量。我们在基线时获得他们的GI诊断(功能性与器质性)、神经质评分(NEO个性问卷)、性虐待和/或身体虐待史，以及两份应对问卷的得分。采用回归分析确定应对措施对健康结局的相对影响及其对教育、胃肠道疾病类型、神经质和虐待严重程度的修正作用。结果：灾害性量表得分越高，自感减少症状能力量表(应对策略问卷)得分越低，健康结局越差。较少的教育，功能性的GT诊断，较高的神经质评分，以及较高的虐待严重程度也导致了较差的健康状况。然而，应对措施显著降低了胃肠道疾病类型和神经质对健康结局的影响。结论：不良适应应对(如灾害化)和自我感觉能力降低可能对健康结局产生不利影响，并可能改变胃肠道疾病类型和神经质对健康结局的影响。
Background: Studies have shown that the nature and quality of coping may positively or negatively affect health outcome; however, this relationship has not been well studied among patients with gastrointestinal (GI) disorders. Objectives: The primary objective was to study the effect of different coping strategies on the health outcome of women with GI disorders and how these coping strategies may modify the effects of education, GI disease type, neuroticism, and abuse severity on health outcome. Methods: We followed 174 patients in a referral GI clinic for 12 months to assess their health status as a derived variable of daily pain, bed disability days, psychological distress, daily dysfunction, number of visits to physicians, and number of surgeries and procedures. We obtained at baseline their GI diagnosis (functional vs. organic), neuroticism score (NEO Personality Inventory), sexual and/or physical abuse history, and scores on two coping questionnaires. Regressions analyses were used to determine the relative effect of the coping measures on health outcome and their modifying effects on education, GI disease type, neuroticism, and abuse severity. Results: A higher score on the Catastrophizing scale and a lower score on the Self-Perceived Ability to Decrease Symptoms scale (Coping Strategies Questionnaire) predicted poor health outcome. Less education, a functional GT diagnosis, a higher neuroticism score, and greater abuse severity also contributed to poor health status. However, the effect of GI disease type and neuroticism on health outcome was significantly reduced by the coping measures. Conclusions: Maladaptive coping (eg, catastrophizing) and decreased self-perceived ability to decrease symptoms may adversely affect health outcome and may modify the effect of GI disease type and neuroticism on health outcome.