Field research on the relationship between stress and disease activity in rheumatoid arthritis.
Field research on the relationship between stress and disease activity in rheumatoid arthritis.
复制标题
类风湿性关节炎应激与疾病活动关系的现场研究。
DOI：
10.1111/j.1749-6632.1999.tb07664.x
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发表时间：
1999
影响因子：
5.2
通讯作者：
Smith,B
中科院分区：
文献类型：
--
作者：
Zautra,AJ;Hamilton,NA;Potter,P;Smith,B
我们回顾了两项实地研究的经验证据，以了解压力生活事件在类风湿性关节炎（RA）患者疾病发作中的作用。与其他没有自身免疫性疾病的关节炎患者相比，RA 患者在心理和生理上预计更容易受到日常生活中压力事件的影响。对两项研究的结果进行了回顾，不仅是为了它们的实质性贡献，也是为了为未来此类实地研究中的测量问题提供指导。一项研究纳入了 41 名 RA 患者，每周对他们进行访谈，当他们的人际压力水平显着增加时，他们会被要求去诊所进行血液检查和关节检查。第二项研究采用了类似的设计，但包括骨关节炎 (OA) 患者和与 RA 样本年龄相似、性别相同的健康对照样本。研究结果支持了以下观点：人际压力源可预测疾病活动的增加。然而，并非所有 RA 患者都表现出这些关系，并且有证据表明，一些患有抑郁症的 OA 参与者在人际压力源后也表现出更高的疾病活动度。压力与疾病关系中存在显着的个体差异，值得在未来的研究中给予更多关注。压力事件评估的重要改进和小组研究设计的改进也被提出，作为压力在疾病过程中作用的研究指南。
We review empirical evidence from two field studies for the role of stressful life events in disease flare‐ups among patients with rheumatoid arthritis (RA). RA patients were expected to be more vulnerable psychologically, and physiologically, to stressful events in their everyday lives than other arthritis patients without an autoimmune disease. Findings from two studies are reviewed both for their substantive contribution, but also to provide guidance on measurement issues in future field research of this kind. One study included 41 patients with RA, who were interviewed weekly and called to a clinic for blood work and joint examinations when their levels of interpersonal stress increased significantly. A second study used a similar design but included comparison samples of patients with osteoarthritis (OA) and healthy controls of similar age and the same gender as the RA sample. The findings provided support for the proposition that interpersonal stressors are predictive of increases in disease activity. Not all RA patients, however, showed these relationships, and there was evidence that some participants with OA who were depressed also showed higher disease activity following interpersonal stressors. Significant individual differences in the stress‐disease relationship were uncovered that deserve greater attention in future studies. Important improvements in the assessment of stressful events and refinements in panel study design are also presented as guides to research on the role of stress in disease processes.