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