Elastyczne radzenie sobie ze stresem a oczekiwania od edukacji terapeutycznej i przestrzeganie zaleceń lekarskich przez pacjentów chorych przewlekle

Abstract

Introduction. A patient’s education, which should help patients acquire and maintain the skills that will enable them to manage their lives when they become ill, is an important element of modem healthcare. Many patients do not comply with the recommendations necessary in the course of therapy if they do not take into account their needs, expectations, and previous experience. In contemporary approach, the patient is mainly responsible for the treatment of chronic diseases as they are the person having a sense of influence on the course of their disease. Such active participation of the patient in their therapy translates into its more positive results. The problem of coping with stress is one of the major issues that health psychologists are investigating. The quality of coping efforts made by an individual and their results in the long term gives accumulated effects on their functioning, also with regard to their health. Coping can be analysed from many perspectives. One of them is the coping flexibility, which indicates an individual’s ability to effectively modify the coping strategies they apply, depending on the requirements of the stressful situation. The goal of the presented study was to verify whether coping flexibility strengthens adaptive functioning in the course of a disease of chronically ill people expressed in their expectations towards therapeutic education and observance of the doctor’s recommendations concerning taking medicines. A positive relation had been assumed between the analysed variables and it was expected that people with coping flexibility would have higher expectations towards education and would abide by the doctor’s recommendations more diligently. Research methods. Three research methods were applied to verify the formulated hypotheses: The Scale of Expectations towards Therapeutic Education OE-15 of Anna Andruszkiewicz and Małgorzata A. Basińska, the Coping Flexibility Scale of Tsukasa Kato and particulars. The study was conducted on a group of 85 chronically ill people, of which 62 (73%) were female and 23 (27%) were male. Average age for the entire group was 44.60 years (5Z>=18.66). The respondents suffered from various chronic conditions, mostly hypertension and other circulatory diseases as well as various auto-immunological diseases, including diabetes and endocrine diseases. Results. No statistically significant differences with regard to adaptive coping were found in relation to the observance of doctors’ recommendations concerning taking medicines. No statistically significant relation between adaptive coping and expectations towards education was found. At the next stage of analysis respondents were divided into three subgroups with regard to their level of adaptive coping, in accordance with the static criterion (mean +/-1/2 SD). The conducted variance analysis of Kruskal-Willis confirmed earlier results and suggested that the level of adaptive coping does not differentiate expectations towards therapeutic education in the sample group of the chronically ill. Conclusion. The obtained results should be performed once again on a larger and homogenous group with regard to the type of disease.