Assessment of Coping Strategies and Their Associations With Health Related Quality of Life in Patients With Chronic Heart Failure: the Brief COPE Restructured.
Assessment of Coping Strategies and Their Associations With Health Related Quality of Life in Patients With Chronic Heart Failure: the Brief COPE Restructured.
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DOI：
10.14740/cr385w
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发表时间：
2015-04
影响因子：
1.9
通讯作者：
Saboonchi F
中科院分区：
文献类型：
--
作者：
Nahlen Bose C;Bjorling G;Elfstrom ML;Persson H;Saboonchi F
慢性心力衰竭 (CHF) 患者需要应对疾病带来的身体限制和心理影响。由于一些应对策略是有益的，而另一些则与死亡率增加和健康相关生活质量 (HRQoL) 恶化有关，因此拥有可靠且有效的工具来检测不同的应对方式非常重要。 Brief COPE 是一种自我报告问卷，以前曾在 CHF 的背景下使用过。然而，目前对于将 Brief COPE 评估的多种应对策略分为更高阶应对类别的理论或经验基础缺乏共识。本研究的主要目的是检验 Brief COPE 的结构，该结构建立在其子量表的高阶分组基础上，以便建立一个由理论考虑支持的评估模型。此外，还检查了应对这些高阶类别与 HRQoL 之间的关联，以确定所选模型在 CHF 背景下的预测有效性。在心力衰竭门诊或心脏病房招募了 183 名诊断为 CHF 的患者。填写自我报告的调查问卷来衡量应对策略和 HRQoL。进行验证性因素分析以调查文献中发现的 Brief COPE 的不同层次结构，以评估 CHF 患者的应对策略。回归分析探讨了总体应对策略与 HRQoL 的关联。简短应对的四因子结构显示了最充分的心理测量特性，包括以问题为中心的应对、回避性应对、以社会支持的应对和以情绪为中心的应对。回避型应对与 CHF 患者的 HRQoL 较差相关。这项研究为 CHF 患者应对策略的四因素模型提供了支持。这可以促进临床和研究环境中的应对评估。
Individuals with chronic heart failure (CHF) need to cope with both the physical limitations and the psychological impacts of the disease. Since some coping strategies are beneficial and others are linked to increased mortality and worse health-related quality of life (HRQoL), it is important to have a reliable and valid instrument to detect different coping styles. Brief COPE, a self-reporting questionnaire, has been previously used in the context of CHF. There is, however, currently a lack of consensus about the theoretical or empirical foundations for grouping the multiple coping strategies assessed by Brief COPE into higher order categories of coping. The main purpose of this study was to examine the structure of Brief COPE, founded on the higher order grouping of its subscales in order to establish an assessment model supported by theoretical considerations. Furthermore, the associations between these higher order categories of coping and HRQoL were examined to establish the predictive validity of the selected model in the context of CHF. One hundred eighty-three patients diagnosed with CHF were recruited at a heart failure outpatient clinic or at a cardiac ward. Self-reported questionnaires were filled in to measure coping strategies and HRQoL. Confirmatory factor analyses were performed to investigate different hierarchical structures of Brief COPE found in the literature to assess coping strategies in patients with CHF. Regression analyses explored associations of aggregated coping strategies with HRQoL. A four factorial structure of Brief COPE displayed the most adequate psychometric properties, consisting of problem focused coping, avoidant coping, socially supported coping and emotion focused coping. Avoidant coping was associated with worse HRQoL in CHF. This study provides support for a four-factor model of coping strategies in patients with CHF. This could facilitate assessment of coping both in clinical and research settings.