Stanisława Steuden

Social support and adaptation to the disease in men and women with psoriasis

Social support was shown to be an important factor buffering negative effects of stress in a range of clinical populations. Little is known, however, about the role of social support in the population of patients with psoriasis although strong psychosocial stress has been implicated in this disease. The objective of this study was to evaluate the association between social support and selected indices of adaptation to life with the disease, including health-related quality of life, depressive symptoms and acceptance of life with the disease, in a sample of patients with psoriasis. Additionally, gender differences in these relationships were analyzed. One-hundred-four patients with psoriasis completed psychological tests measuring disease-related social support, health-related quality of life, depressive symptoms and acceptance of life with the disease. Psoriasis severity was assessed by Psoriasis Area and Severity Index. The patients reporting higher social support levels had significantly higher quality of life, lower depression levels, and higher acceptance of life with the disease. The strengths of these effects, however, were different in women and men. Higher social support was slightly more closely associated with better acceptance of life with the disease in men than in women. However, higher social support was more closely associated to lower depression and better quality of life in women than in men. Among different types of social support, tangible support was found to be the best predictor for the all adaptation indices. Effects of social support perceived by psoriasis patients on adaptation to the disease may be gender-related and exact pathways of these effects may depend on the type on the dimension of social support and the selected type of adaptation indicator. Tangible support seems the most important type of support contributing to better adaptation in both women and men with psoriasis.

Factors accounting for psychosocial functioning in patients with low back pain

Low back pain (LBP) is a chronic disorder which exerts a profound impact on various spheres of psychosocial functioning, including emotional distress, functional limitations and decrements in social contacts. The objective of this study was to investigate the associations between the indices of psychosocial functioning in patients with chronic LBP and a range of psychological factors. Specifically, the study aimed at exploring the relative participation of personality, social support, disease-related cognitive appraisals and coping styles in accounting for the differences in psychosocial functioning of patients with LBP. One-hundred-twenty patients with LBP took part in the study and completed a battery of psychological questionnaires: NEO–Five Factors Inventory, Ways of Coping Questionnaire, Disease-Related Social Support Scale, Disease-Related Appraisals Scale and Psychosocial Functioning Questionnaire (PFQ). The PFQ dimensions were used as dependent variables in a series of stepwise regression analysis models with the scores from other questionnaires entered as independent variables. A cognitive appraisal of the disease in terms of an obstacle was strongly related to all domains of functioning; however, other appraisals (threat, challenge, harm, profit and overall disease importance) were uniquely associated with particular domains of functioning. Deprivation of social support was a significant predictor of distress experienced in interpersonal context and of sense of being disabled. Among basic personality traits, agreeableness was negatively associated with distress in interpersonal context, and conscientiousness was positively related to acceptance of life with the disease. Problem-focus coping was linked to higher acceptance of life with the disease. Among sociodemographic variables, older age and lower educational level were related to greater subjective feelings of being disabled. Pain severity was found unrelated to any of psychosocial functioning domains. Different aspects of psychosocial functioning are best accounted for by diverse patterns of psychological factors, which suggests involvement of different psychological mechanisms in development of LBP-related disability.

Clinical and psychological characteristics of patients with psoriasis reporting various frequencies of pruritus

Pruritus is a common subjective symptom of psoriasis whose levels may be affected by a range of variables. The objective of this study was to evaluate the frequency of pruritus and its associations with clinical and psychological characteristics of psoriasis patients.

Selected determinants of quality of life in women with urinary incontinence

Urinary incontinence (UI) is one of the most common diseases in women. It involves uncontrolled leaking of urine through the urethra. UI incidence depends on age and in certain age groups it can affect up to 60% of the female population. The symptoms can be persistent and due to their embarrassing nature they can lead to significant deterioration of quality of life and psychological functioning. The aim of this study was to investigate the relationship between the quality of life and selected aspects of functioning. Seventy female outpatients of a public clinic in Nałęczów, Poland, were examined, and the following methods were used: the Urinary Incontinence Life Quality Scale (Szymona-Pałkowska, Kraczkowski), Disease-Related Appraisal Scale (Janowski, Steuden), Coping Inventory for Stressful Situations (Endler, Parker), Disease-Related Social Support Scale (Brachowicz, Janowski, Sadowska), and the Knowledge Appraisal Scale for Urinary Incontinence (Szymona-Pałkowska, Kraczkowski). The obtained results suggest that the strongest predictors for the quality of life with UI would be: perception of the disease as an injustice and a challenge (a reverse relationship) and an avoidance-oriented style of coping with stress through companionship seeking (a positive relationship). The duration of the disease and the level of related knowledge proved to be crucial in the analysis of one dimension, i.e. distance to the symptoms.

The Polish version of Skindex-29: psychometric properties of an instrument to measure quality of life in dermatology

Introduction Skin conditions have a negative impact on quality of life and it is necessary to quantify this impact. Skindex-29 is a self-report questionnaire developed to measure dermatology-specific quality of life. Aim The objective of this study is to adapt this questionnaire to Polish conditions. The adaptation procedure involved the works on the linguistic content of the items and testing psychometric properties of the Polish version of Skindex-29, including item characteristics, factorial structure, aspects of reliability and validity. Material and methods Two-hundred and ninety patients (63.4% women and 35.2% men) suffering from a range of skin conditions were recruited from several dermatological out-patient and in-patient clinics in Poland. Quality of life was measured using Skindex-29 and appropriate clinical data were collected. Results The global score of Skindex-29 showed the normal distribution. Cronbachs α reliability coefficients were found to be high to very high for all Skindex-29 indexes. Factor analysis yielded four factors, in contrast to the original version of the questionnaire, for which a three-factor solution had been reported. Skindex-29 validity was demonstrated by showing the differences in the quality of life scores across different diagnostic categories, and between in-patients and out-patients. Skindex-29 global scores were found to be significantly predicted by the localization of the skin lesions on legs, anogenital areas and palms. Conclusions The findings of this study support reliability and validity of the Polish version of Skindex-29, but they also raise questions to its three-factor structure.

Coping with stress and quality of life in women with stress urinary incontinence.

Introduction Urinary incontinence (UI) involves uncontrolled leakage of urine through the urethra as a result of damage to its sphincter muscle and a disturbed function of the urogenital diaphragm within the pelvis minor. The symptoms of UI radically impair psychological, somatic, and social functioning. The aim of each disease stress coping process is to reduce the impact of harmful agents as well as the acquisition of necessary preventive measures in order to combat the disorder. Aim of the study was to assess the relationship between coping styles used when dealing with stress associated with disease and the quality of life. Material and methods The study was carried out at an outpatients’ clinic located in the Lublin Province (eastern Poland), covering 150 women with diagnosed stress urinary incontinence, aged between 32 and 79. The following methods were used: (a) Coping Inventory for Stressful Situations (Endler, Parker) to assess coping styles, (b) CASP-19 scale (Higgins, Hyde, Wiggins, Blade) to measure the overall quality of life, and (c) Urinary Incontinence Life Quality Scale (Szymona-Pałkowska, Kraczkowski). Results The preferred style in the studied group of women was Task-Oriented Coping. This style is associated with a low score on the Independence from Symptoms scale and low Control, being simultaneously correlated with Autonomy and Self-Realisation. Emotion-Oriented Coping is associated with low psychological, physical and social well-being, as well as with little independence from the disease symptoms, little pleasure and self-realisation, but it gives a sense of internal control. Avoidance-Oriented Coping does not significantly correlate with any of the Overall Quality of Life dimensions. Conclusions Women suffering from UI tend to try to solve their problem by means of cognitive transformation. In their situation, clinging to the problem turns out to be a depressing factor and entails a lower quality of their life.

Polish Adaptation of the Death Attitude Profile—Revised:

The article presents the results of work on the Polish adaptation of the Death Attitude Profile—Revised by Wong, Reker, and Gesser (1994). The psychometric properties of the Polish version of the tool have been described. The results are consistent with the original version of the questionnaire and confirm that the Polish version of Death Attitude Profile—Revised fulfils the psychometric requirements for psychological tests and, as a result, can be applied in scientific research. The final version of the questionnaire consists of 32 items (including 31 diagnostic ones) that make up five dimensions of attitudes toward death: (a) Fear of Death, (b) Death Avoidance, (c) Neutral Acceptance, (d) Escape Acceptance, and (e) Approach Acceptance. The questionnaire was tested on 1,285 subjects aged 13 to 90 years (M = 47.27, SD = 18.21). Reliability values (Cronbach’s α) for individual scales vary from α = .63 to α = .89. Confirmatory factor analysis was used to evaluate the validity of the questionnaire.