中華心理衛生協會

Purpose: Patients' sense of self-efficacy in disease-management and the coping strategies they adopt play an important role in their ability to control chronic illness. The functions identified for emotion-focused coping strategies were inconsistent in past studies, and researchers did not examine the relationship between the patient’s sense of self-efficacy and the coping strategies they applied to handle their illness The goal of the present study is to discriminate the functions of different emotion-focused coping strategies, and to test the mediation effect of the coping strategy selected on the patient's sense of self-efficacy. Methods: This study was conducted in two phases during 2007- 2008. In both phases the participants had at least one of the following chronic illnesses: hypertension, diabetes, hyperlipidemia, or gout. In the first phase, 76 participants (mean age 55.87, 46 men) were surveyed and 151 participants (mean age 57.58, 70 men) in the second phase with measurements of self-efficacy, and problem- and emotion-focused coping strategies of disease management. Results: Emotion-focused coping could be divided into two categories: (1) active emotion-focused coping focused on stabilization of emotion for promoting symptom control, and (2) defensive emotion-focused coping focused on protecting the self from the health-threats of chronic illness. Self-efficacy correlated significantly with problem-focused and active emotion-focused coping. The latter also mediated the effect of self-efficacy on illness adaptation. Defensive emotion-focused coping worsened illness adaptation. Conclusions: The results support the assertion that patients can cope with chronic illness in a problem-focused way, but they should differentiate their emotion-focused coping carefully in terms of the origins of their emotions, since different emotion-focused coping strategies requires different intervention strategies.