The Relationship Between Spirituality, Psychosocial Adjustment to Illness, and Health-Related Quality of Life in Patients With Advanced Chronic Kidney Disease
The Relationship Between Spirituality, Psychosocial Adjustment to Illness, and Health-Related Quality of Life in Patients With Advanced Chronic Kidney Disease
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DOI：
10.1016/j.jpainsymman.2012.02.019
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发表时间：
2013-02-01
影响因子：
4.7
通讯作者：
Jhangri, Gian S.
中科院分区：
文献类型：
--
作者：
Davison, Sara N.;Jhangri, Gian S.
上下文灵性可以促进对疾病的心理社会调整，这可能是一种机制，通过这种机制，在生命限制性疾病的背景下，具有更大的存在幸福感（EWB）的患者可以体验到更好的健康相关生活质量（HRQL）。本研究探讨了晚期慢性肾脏病患者对疾病的心理社会适应、EWB和HRQL之间的关系，并试图确定对疾病的适应是否介导了EWB和HRQL之间的关系。这是一项对253例流行的4期或5期慢性肾脏疾病和透析患者进行的队列研究。参与者完成了精神健康量表、疾病心理适应量表（PAIS）-自我报告和肾透析生活质量简表。对疾病的心理社会适应与HRQL高度相关，分别占身体和精神HRQL评分方差的29%和27%。虽然PAIS领域与EWB相关，但在考虑所有PAIS领域后，EWB仍然是HRQL的重要预测因子。在心理困扰和大家庭关系领域的调整似乎中介EWB和HRQL之间的关系。在心理困扰和大家庭关系领域的调整似乎调解一些有益的影响，EWB HRQL。灵性，然而，提供了独特的差异，在患者的HRQL，独立于他们的心理社会调整。这项研究证明了针对疾病和灵性的心理社会调整的重要性，以保持或提高透析前和透析患者的HRQL。J Pain Symptom Manage 2013;45：170-178. (C)2013年美国癌症疼痛缓解委员会。爱思唯尔公司出版All rights reserved.
Context. Spirituality may promote psychosocial adjustment to illness, and this may be a mechanism by which patients with greater existential well-being (EWB) experience better health-related quality of life (HRQL) in the context of life-limiting illness.Objectives. This study explored the relationship between psychosocial adjustment to illness, EWB, and HRQL in patients with advanced chronic kidney disease and sought to determine whether adjustment to illness mediates the relationship between EWB and HRQL.Methods. This was a cohort study of 253 prevalent Stage 4 or 5 chronic kidney disease and dialysis patients. Participants completed the Spiritual Well-Being Scale, the Psychological Adjustment to Illness Scale (PAIS)-Self-Report, and the Kidney Dialysis Quality of Life Short Form.Results. Psychosocial adjustment to illness was highly correlated with HRQL, accounting for 29% and 27% of the variance in physical and mental HRQL scores, respectively. Although PAIS domains were associated with EWB, EWB remained a significant predictor of HRQL after all PAIS domains were considered. Adjustment in the domains of psychological distress and extended family relationships did appear to mediate some of the relationship between EWB and HRQL.Conclusion. Adjustment in the domains of psychological distress and extended family relationships appears to mediate some of the beneficial effect of EWB on HRQL. Spirituality, however, provides unique variance in patients' HRQL, independent of their psychosocial adjustment. This study testifies to the importance of targeting both psychosocial adjustment to illness and spirituality as ways to preserve or enhance HRQL of predialysis and dialysis patients. J Pain Symptom Manage 2013;45:170-178. (C) 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.