应对措施在复发性尿路感染患者的健康感知与心理健康之间的中介作用:尿路感染疾病过程模型。

IF 2.4 Q2 PSYCHOLOGY, CLINICAL
Health Psychology and Behavioral Medicine Pub Date : 2024-11-03 eCollection Date: 2024-01-01 DOI:10.1080/21642850.2024.2420806
Abigail F Newlands, Melissa L Kramer, Kayleigh Maxwell, Jessica L Price, Katherine A Finlay
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引用次数: 0

摘要

背景:复发性尿路感染(rUTI)与严重的症状和生活质量负担有关。鉴于复发性尿路感染与其他泌尿系统疾病不同,在诊断和管理方面存在独特的挑战、医疗保健的失望和耻辱感,因此需要具体确定该患者群体所经历的关键疾病过程。本研究旨在通过感知健康状况、心理健康和应对措施,确定有助于提高尿路感染患者生活质量的独特疾病过程和感知。研究方法一个由患有急性尿路感染的成年人(N = 389,96.9% 为女性)组成的国际样本完成了一项横断面调查,其中包括以下标准化问卷:EuroQoL EQ-5D-5L、Patient Health Questionnaire 9 (PHQ-9)、Generalised Anxiety Disorder 7 (GAD-7)、Connor-Davidson Resilience Scale-10 (CD-RISC-10)、Pain Catastrophising Scale (PCS)。此外,还对社会人口学特征进行了评估。通过建立结构方程模型,确定了导致急性尿路感染患者心理健康的基本结构,建立了 "急性尿路感染疾病过程模型"。结果显示在控制了家庭收入和年龄的影响后(p R 2 = .81),"感知健康状况 "和 "心理健康 "之间的正向关系部分由 "rUTI 应对 "调节,且局部和整体拟合良好。总之,在急性尿路感染患者的健康状况感知与心理健康之间的正相关关系中,急性尿路感染应对技能占了相当大的比例,这种应对技能因恢复能力而增强,因疼痛灾难化而减弱。这项新研究发现了一种独特的脆弱患者表型,即年龄较轻和/或社会经济地位较低的患者更有可能出现较差的急性肠梗阻健康状况和心理健康,因此可能需要进一步的支持。结论急性尿路感染疾病过程模型确定了临床上描述急性尿路感染患者个性化疾病认知和元认知策略的关键需求,揭示了以患者为中心、针对疾病认知和应对策略的干预措施需要优先考虑,以提高患者的治疗效果和急性尿路感染患者的生活体验。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The mediating role of coping in the relationship between perceived health and psychological wellbeing in recurrent urinary tract infection: the rUTI Illness Process Model.

Background: Recurrent urinary tract infection (rUTI) is associated with significant symptom and quality of life burden. Given the unique challenges in diagnostics and management, healthcare disillusionment and stigmatisation which distinguish rUTI from other urological conditions, specific identification of the key illness processes experienced by this patient population is required. This study aimed to identify the unique illness processes and perceptions that contribute to quality of life in rUTI, through perceived health status, psychological wellbeing, and coping. Methods: An international sample of adults living with rUTI (N = 389, 96.9% female) completed a cross-sectional survey comprising the following standardised questionnaires: the EuroQoL EQ-5D-5L, Patient Health Questionnaire 9 (PHQ-9), Generalised Anxiety Disorder 7 (GAD-7), Connor-Davidson Resilience Scale-10 (CD-RISC-10), Pain Catastrophising Scale (PCS). Sociodemographic characteristics were also assessed. Structural equation modelling was conducted to identify the underlying constructs which contributed to psychological wellbeing in rUTI, establishing the 'rUTI Illness Process Model'. Results: The positive relationship between 'perceived health status' and 'psychological wellbeing' was partially mediated by 'rUTI coping', after controlling for the impact of household income and age (p < .001). The model demonstrated a large effect size (R 2 = .81) and good local and global fit. Overall, rUTI coping skills, boosted by resilience and weakened by pain catastrophising, contribute to a significant proportion of the positive relationship between perceived health status and psychological wellbeing in rUTI. A uniquely vulnerable patient phenotype emerges from this new research, with patients who are younger and/or of lower socioeconomic status at greater risk of poorer rUTI health outcomes and psychological wellbeing, potentially requiring further support. Conclusions: The rUTI Illness Process Model establishes the crucial need to clinically characterise the individualised illness perceptions and metacognitive strategies held by people living with rUTI, revealing that patient-centred interventions targeting illness perceptions and coping strategies require prioritisation to enhance patient outcomes and the patient experience of living with rUTI.

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来源期刊
CiteScore
3.50
自引率
3.70%
发文量
57
审稿时长
24 weeks
期刊介绍: Health Psychology and Behavioral Medicine: an Open Access Journal (HPBM) publishes theoretical and empirical contributions on all aspects of research and practice into psychosocial, behavioral and biomedical aspects of health. HPBM publishes international, interdisciplinary research with diverse methodological approaches on: Assessment and diagnosis Narratives, experiences and discourses of health and illness Treatment processes and recovery Health cognitions and behaviors at population and individual levels Psychosocial an behavioral prevention interventions Psychosocial determinants and consequences of behavior Social and cultural contexts of health and illness, health disparities Health, illness and medicine Application of advanced information and communication technology.
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