Use of self-management behaviors to cope with rheumatoid arthritis stressors
Use of self-management behaviors to cope with rheumatoid arthritis stressors
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DOI：
10.1002/art.21580
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发表时间：
2005-12-15
期刊：
影响因子：
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通讯作者：
Katz, PP
中科院分区：
文献类型：
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作者：
Katz, PP
客观的。旨在检查用于应对 5 种类风湿性关节炎 (RA) 相关压力源（疼痛、疲劳、身体限制、关节变化和症状不可预测性）的自我管理行为以及自我管理行为的使用与进行生活活动的能力之间的关系。方法。数据来自对 511 名 RA 患者的电话采访。向参与者提供了针对每种压力源的自我管理行为清单，并要求他们指出他们在过去一年中使用过哪些行为。同时评估生活活动表现（基线）和一年后（随访）。计算受影响的活动数量（难以进行或无法进行）以及个人完全无法进行的活动数量。使用多元回归分析来检查感知压力源影响和关节炎教育与策略使用的关联以及自我管理行为与生活活动表现的关联。结果。确定了四种自我管理策略：适应、积极补救、社交和坚持。压力源更大的感知影响与针对每种压力源使用更多的自我管理策略相关（beta = 0.43-0.73，所有 P < 0.0001），并与住宿的使用（P = 0.26-0.29，P < 0.0001）、社交（0 = 0.23-0.43，P < 0.0001）和毅力（0 = 0.29-0.46，P < 0.0001）策略。基线时更多地使用适应策略与随访时受影响的活动数量增加相关（β = 0.11，P < 0.05）；更多地使用坚持策略与无法执行的活动的减少相关（β = -0.13，P < 0.01）。结论。自我管理行为很常用，可能有助于防止丧失进行生活活动的能力。
Objective. To examine self-management behaviors used to cope with 5 rheumatoid arthritis (RA)-related stressors (pain, fatigue, physical limitations, joint changes, and symptom unpredictability) and the relationship between use of selfmanagement behaviors and ability to perform life activities.Methods. Data were from telephone interviews of 511 persons with RA. Participants were presented with lists of self-management behaviors for each stressor and asked to indicate which they had used in the past year. Performance of life activities was assessed concurrently (baseline) and 1 year later (followup). The number of activities affected (difficulty performing or unable to perform) and the number that individuals were completely unable to perform were calculated. Multiple regression analyses were used to examine the association of perceived stressor impact and arthritis education with strategy use and the association of self-management behaviors with performance of life activities.Results. Four self-management strategies were identified: accommodation, active remediation, social, and perseverance. Greater perceived impact of stressors was associated with use of more self-management strategies in total for each stressor (beta = 0.43-0.73, all P < 0.0001) and with use of accommodation (P = 0.26-0.29, P < 0.0001), social (0 = 0.23-0.43, P < 0.0001), and perseverance (0 = 0.29-0.46, P < 0.0001) strategies. Greater use of accommodation strategies at baseline was associated with an increase in the number of activities affected at followup (beta = 0.11, P < 0.05); greater use of perseverance strategies was associated with a decrease in activities unable to perform (beta = -0.13, P < 0.01).Conclusion. Self-management behaviors are commonly used and may help prevent loss of the ability to perform life activities.