General coping strategies and their impact on quality of life in older adults with schizophrenia.
General coping strategies and their impact on quality of life in older adults with schizophrenia.
复制标题
一般应对策略及其对老年精神分裂症患者生活质量的影响。
DOI：
10.1016/j.schres.2010.12.023
复制
发表时间：
2011
影响因子：
4.5
通讯作者：
Begum,Nurun
中科院分区：
文献类型：
--
作者：
Cohen,CarlI;Hassamal,SameerK;Begum,Nurun
背景具体症状应对策略和一般应对策略都可能影响精神分裂症患者的幸福感。关于患有精神分裂症的老年人如何采取各种应对方式的数据很少。本研究考察了老年精神分裂症患者使用的一般应对策略的类型，并考察了各种应对策略对生活质量的影响程度。方法精神分裂症组由198名55岁及以上居住在社区并在45岁之前发展为精神分裂症的人组成。社区对照组(n=113)采用随机选择的区组招募。认知型、工具型和回避型应对量表是基于主成分分析建立的，主成分分析采用等分旋转的方法对来自自报应对问卷的条目进行轮换。采用改良的Yanos和Moos综合模型评估各应对策略量表对生活质量指数的直接和中介效应。结果成人精神分裂症患者及其同龄人最常使用认知应对策略，在该量表上得分无显著差异。对于精神分裂症患者，积极应对策略--认知型和工具型--的使用频率高于回避型策略。积极应对策略和回避应对策略都在精神症状对生活质量的影响中起到了中介作用，并对生活质量的提高起到了独立的作用；但对其他应激源变量没有影响。结论本研究表明，一般应对策略，尤其是更积极的应对策略，可能有助于减少精神症状对生活质量的不利影响，并对生活质量产生直接影响。这些策略可以补充特定症状的方法。
BACKGROUNDBoth symptom specific and general coping strategies may affect the well-being of persons with schizophrenia. There are little data on how older adults with schizophrenia employ various coping styles. This study examines the types of general coping strategies used by older persons with schizophrenia and examines the extent to which the various coping strategies affect quality of life.METHODSThe schizophrenia group consisted of 198 persons aged 55 and over living in the community who developed schizophrenia before age 45. A community comparison group (n=113) was recruited using randomly selected block-groups. Cognitive, instrumental, and avoidant coping scales were created based on a principal component analysis with equamax rotation of items from a self-report coping inventory. A modified version of Yanos and Moos' integrative model was used to assess the direct and mediating effects of each of the coping strategies scales on the Quality of Life Index.RESULTSOlder adults with schizophrenia and their age peers in the general community most commonly use cognitive coping strategies, and there was no significant difference in their scores on this scale. For persons with schizophrenia, the active coping strategies – cognitive and instrumental – were used more frequently than the avoidant strategies. Both active and avoidant strategies mediated the impact of psychiatric symptoms on quality of life as well as contributing independently to improving life quality; however, they had no impact on the other stressor variables.CONCLUSIONThis study suggests that general coping strategies, especially more active approaches, may be useful in diminishing the adverse impact of psychiatric symptoms on quality of life as well as having direct effects on life quality. Such strategies can complement symptom specific approaches.