The Influence of Coping Strategies and Solution-Focused Thinking on Disease Activity and Functional Impairment in Ankylosing Spondylitis

Yıl 2025, Cilt: 35 Sayı: 6, 1239 - 1245, 31.12.2025

I. Merve Uçar Baytaroğlu , Faika Şanal Karahan

https://doi.org/10.54005/geneltip.1731556

Öz

Aims: This study aimed to assess the coping strategies and solution-focused thinking skills of patients with AS and to examine the relationship between these psychological characteristics and clinical disease severity, as measured by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Functional Index (BASFI).

Methods: This cross-sectional study included 128 patients with AS from a rheumatology outpatient clinic. Data were collected on demographics, disease activity (BASDAI), functional status (BASFI), solution-focused thinking (SFI), and coping strategies (COPE-R). The analysis involved descriptive statistics, Pearson correlation analysis, and structural equation modeling (SEM).

Results: The mean age of the cohort was 42.4 years, and 48% were female. They presented with moderate disease activity (mean BASDAI: 4.8 ± 2.1) and mild-to-moderate functional impairment (mean BASFI: 3.9 ± 1.8). Adaptive psychological traits, such as Goal Orientation (SFI), were strongly and positively correlated with proactive coping strategies like Self-Help (r = 0.52) and Approach Coping (r = 0.47). Conversely, Problem Disengagement was positively associated with maladaptive styles like avoidance (r = 0.41) and self-punishment (r = 0.33). Goal Orientation was negatively correlated with both disease activity (r = -0.42) and functional impairment (r = -0.39), while avoidance coping showed the strongest positive correlation with poorer outcomes (r = 0.48 for BASDAI and r = 0.45 for BASFI). The SEM analysis confirmed that adaptive strategies predicted better outcomes, whereas maladaptive strategies, like avoidance, predicted worse clinical status.

Conclusions: Coping styles and solution-focused thinking are significant and modifiable predictors of disease severity in patients with AS. Adaptive strategies such as goal orientation appear to be protective, while maladaptive strategies, particularly avoidance, are associated with a greater disease burden. These findings underscore the importance of integrating psychological interventions into multidisciplinary care to improve patient-centered management and potentially disrupt the cycle of inflammation and disability in AS.

Anahtar Kelimeler

ankylosing spondylitis , coping , solution-focused , disease severity

Ankilozan Spondilit Hastalarında Başa Çıkma Stratejileri ve Çözüm Odaklı Düşünmenin Hastalık Aktivitesi ve Fonksiyonel Bozukluk Üzerindeki Etkisi

Öz

Amaç: Bu çalışmanın amacı, AS hastalarının başa çıkma stratejilerini ve çözüm odaklı düşünme becerilerini değerlendirmek ve Bath Ankilozan Spondilit Hastalık Aktivite Endeksi (BASDAI) ve Fonksiyonel Endeksi (BASFI) ile ölçülen bu psikolojik özellikler ile klinik hastalık şiddeti arasındaki ilişkiyi incelemektir.

Yöntem: Bu kesitsel çalışmaya romatoloji polikliniğinden 128 AS hastası dahil edilmiştir. Demografik bilgiler, hastalık aktivitesi (BASDAI), fonksiyonel durum (BASFI), çözüm odaklı düşünme (SFI) ve başa çıkma stratejileri (COPE-R) ile ilgili veriler toplanmıştır. Analiz, tanımlayıcı istatistikler, Pearson korelasyon analizi ve yapısal eşitlik modellemesi (SEM) ile gerçekleştirilmiştir.

Sonuçlar: Kohortun ortalama yaşı 42,4 idi ve %48'i kadındı. Hastalar orta derecede hastalık aktivitesi (ortalama BASDAI: 4,8 ± 2,1) ve hafif ila orta derecede fonksiyonel bozukluk (ortalama BASFI: 3,9 ± 1,8) ile başvurdu. Hedef Odaklılık (SFI) gibi uyarlanabilir psikolojik özellikler, Kendi Kendine Yardım (r = 0,52) ve Yaklaşımla Başa Çıkma (r = 0,47) gibi proaktif başa çıkma stratejileriyle güçlü ve pozitif korelasyon göstermiştir. Tersine, Sorundan Uzaklaşma, kaçınma (r = 0,41) ve kendini cezalandırma (r = 0,33) gibi uyumsuz başa çıkma stilleriyle pozitif ilişkili bulunmuştur. Hedef Odaklılık, hem hastalık aktivitesi (r = -0,42) hem de fonksiyonel bozukluk (r = -0,39) ile negatif korelasyon gösterirken, kaçınma başa çıkma, daha kötü sonuçlarla en güçlü pozitif korelasyon göstermiştir (BASDAI için r = 0,48 ve BASFI için r = 0,45). SEM analizi, uyum stratejilerinin daha iyi sonuçları öngördüğünü, kaçınma gibi uyumsuz stratejilerin ise daha kötü klinik durumu öngördüğünü doğrulamıştır.

Tartışma: Başa çıkma stilleri ve çözüm odaklı düşünme, AS hastalarında hastalık şiddetinin önemli ve değiştirilebilir belirleyicileridir. Hedef odaklılık gibi uyum stratejileri koruyucu görünürken, uyumsuz stratejiler, özellikle kaçınma, daha büyük hastalık yükü ile ilişkilidir. Bu bulgular, hasta merkezli yönetimi iyileştirmek ve AS'de iltihaplanma ve sakatlık döngüsünü potansiyel olarak bozmak için psikolojik müdahalelerin multidisipliner bakıma entegre edilmesinin önemini vurgulamaktadır.

Anahtar Kelimeler

ankilozan spondilit , başa çıkma , çözüm odaklı , hastalık şiddeti , hastalık aktivitesi

Kaynakça

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