Magnitude and sources of distress in mid-life adults with chronic medical illness: an exploratory mixed-methods analysis
Magnitude and sources of distress in mid-life adults with chronic medical illness: an exploratory mixed-methods analysis
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DOI：
10.1080/13548506.2017.1384554
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发表时间：
2018-01-01
影响因子：
3.8
通讯作者：
Huffman, Jeff C.
中科院分区：
文献类型：
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作者：
Madva, Elizabeth N.;Gomez-Bernal, Federico;Huffman, Jeff C.
大多数中年人至少有一种慢性疾病（CMC），并且有发展其他CMC的风险。特定于这个生命阶段的应激源可能通过阻碍健康行为而促进CMC的发展。本研究的目的是比较患有CMC的中年和非中年成年人之间的痛苦来源和强度，因为它们与健康行为有关。我们采用混合方法，通过分析精神症状和心理健康的定量自我报告措施，并进行深入的半结构化定性访谈，以确定三组CMC患者（心力衰竭，2型糖尿病和冠状动脉疾病）的压力来源。通过独立样本t检验比较了自我报告措施的组间差异，并通过卡方分析比较了访谈记录的相关主题。我们发现，中年参与者（n = 30）报告说，（抑郁/焦虑）比非中年（n = 62）参与者（医院焦虑抑郁量表评分13.8 [SD 7.3] vs. 10.6 [SD 6.6]; t（90）=2.13; P = 0.035），定性分析揭示了几种特定的压力来源在中年人中更为常见（P <0.001）。针对这一人群需求的干预措施可以减少痛苦，改善健康行为，并对公共卫生产生重大影响。
Most mid-life adults have at least one chronic medical condition (CMC) and are at risk for developing additional CMCs. Stressors specific to this life stage may contribute to CMC development by hindering healthy behaviors. The goal of this study was to compare sources and intensity of distress, as they relate to health behaviors, between mid-life and non-mid-life adults with CMCs. We utilized a mixed-methods approach by analyzing quantitative self-report measures of psychiatric symptoms and psychological well-being, with in-depth, semi-structured qualitative interviews to identify sources of stress in three cohorts of patients with CMCs (heart failure, type 2 diabetes, and coronary artery disease). Between-group differences on self-report measures were compared via independent samples t-tests and relevant themes from interview transcripts were compared via chi-square analysis. We found that mid-life participants (n = 30) reported greater psychological distress (depression/anxiety) than non-mid-life (n = 62) participants (Hospital Anxiety and Depression Scale scores 13.8 [SD 7.3] vs. 10.6 [SD 6.6]; t(90)=2.13; p = .035), and qualitative analysis revealed several specific sources of stress significantly more common (p < .001) in mid-life adults. Interventions targeting the needs of this population could reduce distress, improve health behaviors, and have a major impact on public health.