การรับรู้ความเจ็บป่วยและการเผชิญปัญหาของผู้ที่เป็นอะโครเมกาลี

Abstract

This descriptive correlational study aimed to assess the level of illness representation, the level of coping, and the relationship between illness representation and coping of persons with acromegaly. Twenty-nine patients with acromegaly were followed - up at the out - patient endocrinology and metabolism department, as well as at the out-patient medicine department of a tertiary hospital in souther Thailand. All acromegaly patients were purposively selected. Instruments used for data collection included (1) The Demographic, and Illness and Treatment Questionnaire; (2) The Revised Illness Perception Questionnaire (IPQ-R) and The Illness Perception and Coping Open - ended Questionnaire (OEQ); and (3) The Brief Coping To Problem Experienced Inventory (Brief COPE) Questionnaires. The content validity of all instruments was examined by three experts. The test - retest reliability of the IPQ-R and the Brief COPE were examined yielding correlation coefficients ranging from 0.91 to 1.00 and 0.83 to 1.00, respectively. Descriptive statistics were used to analyze demographic data, illness and treatment data, level of illness perception, and level of coping. Spearman's rank correlation was used to assess the relationship between illness perception and coping. The results revealed the following: 1. Illness perception was classified into 8 components 1.1 Participants perceived that the most common symptoms associated with acromegaly disease were broadened hands and feet, as well as facial changes (93.1 % equally). Snoring, dental problems, carpal tunnel syndrome, headaches and gaining weight were reported by 69%, 65.5%, 65.5%, 62.1% and 62.1%, respectively. 1.2 Participants perceived that the causes of acromegaly disease were abnormal hormone (M = 3.48, SD = 1.27), chance or bad luck (M = 3.21, SD = 1.59), poor medical care in the past (M = 2.93, SD = 1.46) and ageing (M = 2.55, SD = 1.47). 1.3 Participants perceived that the timeline of acromegaly disease would be chronic and of long duration at the moderate level (M = 19.37, SD = 3.94). 1.4 Participants perceived that the timeline of acromegaly disease was cyclical at the moderate level (M = 13.03, SD = 3.08). 1.5 Participants perceived that acromegaly disease had negative consequences at the moderate level (M = 21.59, SD = 6.27). 1.6 Participants perceived that the cure/controllability was personal control and that the effectiveness of treatment was at the higher level (M = 19.55, SD = 3.92; M = 21.28, SD = 2.90, respectively). 1.7 The illness coherence of participants was at the moderate level (M = 16.62, SD = 4.91). 1.8 Emotional representations of participants were negative emotional responses in the moderate level (M = 15.03, SD = 8.07). 2. Coping strategies that the participants used at a high level were consisted of emotional support (M = 7.24, SD = 1.24), active coping (M = 6.89, SD = 1.47), acceptance (M = 6.89, SD = 1.72), positive reframing (M = 6.51, SD = 1.61) and planning (M = 6.06, SD = 1.62). 3. Relationship between illness perception and coping 3.1 The timeline component was negative by correlated with venting at a moderate level (r, = -37, p <.05). 3.2 The consequences component was positive by correlated with planning at a moderate level (r, - 42, p <.05). 3.3 The personal control component was negative by correlated with behavioral disengagement, self - distraction and religion at moderate levels (r; = -45, -45 and -39, p <05). 3.4 The illness coherence component was positive by correlated with active coping at a moderate level (r, - ,38, p <,05). 3.5 The emotional representations component was positive by correlated with behavioral disengagement (r, - ,50, p <,01) and planning (r, - 42, p <.05) at moderate levels. The findings of this study provide basic understanding of illness representation and coping strategies of patients with acromegaly, which nurses can use for counseling and nursing care planning at specific for patients with acromegaly.