孤独感和社会支持对哮喘和慢性阻塞性肺病患者使用急性医疗服务和症状加重的影响

IF 1.6 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Journal of Clinical Psychology in Medical Settings Pub Date : 2024-10-05 DOI:10.1007/s10880-024-10046-0
Patric J Leukel, John D Piette, Aaron A Lee
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引用次数: 0

摘要

在患有哮喘或慢性阻塞性肺病的成年人中,孤独感和低社会支持与不良健康后果相关。虽然社会支持与孤独感相关,但低社会支持既不是产生孤独感的必要条件,也不是产生孤独感的充分条件。本研究比较了 206 名成人哮喘患者和 308 名成人慢性阻塞性肺病患者中,孤独感和社会支持与症状加重(即呼吸系统健康急性恶化)和急性医疗服务使用(即住院、急诊就诊)之间的相对关系。我们采用了不同的逻辑回归模型来同时检验孤独感和社会支持与每种结果之间的关联。在患有哮喘的成年人中,孤独感与更高的住院几率相关(AOR = 2.81,95%CI [1.13,7.02]),而低社会支持则与之无关(AOR = 1.44,95%CI [0.78,2.65])。然而,孤独感和社会支持都与哮喘成人中任何其他急性医疗服务的使用或症状加重无关。在患有慢性阻塞性肺病的成年人中,孤独感和更多的社会支持与症状加重的几率增加有关(AOR = 1.67,95%CI [1.03,2.69];AOR = 1.36,95%CI 1.02,1.83])和住院(AOR = 3.46,95%CI [1.65,7.24];AOR = 1.92,95%CI [1.15,3.22]),但只有社会支持与急诊室就诊显著相关(AOR = 1.72,95%CI 1.12,2.66])。这些研究结果支持了之前的研究,即孤独感和社会支持是患者身体症状和服务使用的相关但独立的决定因素。
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Impact of Loneliness and Social Support on Acute Health Service Use and Symptom Exacerbation Among Adults with Asthma and COPD.

Loneliness and low social support are associated with negative health outcomes among adults with asthma or COPD. Although social support is correlated with loneliness, low social support is neither necessary nor sufficient for the experience of loneliness. This study compares the relative association of loneliness and social support on symptom exacerbation (i.e., acute deteriorations in respiratory health) and acute health service utilization (i.e., hospitalizations, emergency department visits) among 206 adults with asthma and 308 adults with COPD. Separate logistic regression models were used to simultaneously examine the association of loneliness and social support with each outcome. Among adults with asthma, loneliness was associated with greater odds of hospitalization (AOR = 2.81, 95%CI [1.13, 7.02]), while low social support was not (AOR = 1.44, 95%CI [0.78, 2.65]). However, neither loneliness nor social support were associated with any other acute health service use or symptom exacerbation among adults with asthma. Among adults with COPD, loneliness, and greater social support were associated with increased odds of symptom exacerbation (AOR = 1.67, 95%CI [1.03, 2.69]; AOR = 1.36, 95%CI 1.02, 1.83]) and hospitalization (AOR = 3.46, 95%CI [1.65, 7.24]; AOR = 1.92, 95%CI [1.15, 3.22]), but only social support was significantly associated with ED visits (AOR = 1.72, 95%CI 1.12, 2.66]). These findings support prior research demonstrating that loneliness and social support are related but separate determinants of patients' physical symptoms and service utilization.

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来源期刊
CiteScore
4.00
自引率
4.50%
发文量
93
期刊介绍: Journal of Clinical Psychology in Medical Settings is an international forum for the publication of peer-reviewed original papers related to all areas of the science and practice of psychologists in medical settings. Manuscripts are chosen that have a broad appeal across psychology as well as other health care disciplines, reflecting varying backgrounds, interests, and specializations. The journal publishes original research, treatment outcome trials, meta-analyses, literature reviews, conceptual papers, brief scientific reports, and scholarly case studies. Papers accepted address clinical matters in medical settings; integrated care; health disparities; education and training of the future psychology workforce; interdisciplinary collaboration, training, and professionalism; licensing, credentialing, and privileging in hospital practice; research and practice ethics; professional development of psychologists in academic health centers; professional practice matters in medical settings; and cultural, economic, political, regulatory, and systems factors in health care. In summary, the journal provides a forum for papers predicted to have significant theoretical or practical importance for the application of psychology in medical settings.
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