Problem specification of psychosocial and physical sequelae in ankylosing spondylitis : phase I of a competency-based model of coping

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Authors
Nemes, Lewis
Advisor
Nicholas, Donald R.
Issue Date
1989
Keyword
Degree
Thesis (Ph. D.)
Department
Department of Counseling Psychology and Guidance Services
Other Identifiers
Abstract

The purpose of this two stage exploratory study was to investigate the psychosocial, and physical problems associated with a chronic form of arthritis, Ankylosing Spondylitis (AS), following the format of Problem Specification' suggested by the competency-based model of coping (Goldfried and D'Zurilla, 1969). The first stage goal identified problem thoughts, feelings, and situations associated with AS, by thirteen AS sufferers, two physicians, two physical therapists, and ten significant others. The method for obtaining first stage information was an author constructed structured telephone interview. The second stage goal was the development of an author constructed survey instrument, the Inventory of Problems for Ankylosing Spondylitis (IPAS) completed by Iii individuals with AS, to identify problem frequency, and severity, both for the past twelve months, and for the total time a problem had been present. The second stage included a measure of social support, the Family Relationship Index, consisting of three scales from the Family Environmental Scales (Moos and Moos, 1986).Four areas of exploration were undertaken by this study which included: 1) Taxonomy of AS Problems - identification of AS problems 2) Frequency and Severity - how are identified problems rated and rank ordered 3) Social Support - how does social support affect responses to identified problems, and demographics 4) Demographics - how do such factors as age or gender affect responses to identified problems.The descriptive analysis confirmed that problems in the IPAS are problems experienced by the sample of AS participants. Items sorted into three categories of physical, relationship, and intrapersonal content areas were subjected to post hoc principle component analyses, yielding forty-five factors. Principle component analyses were conducted on first order factors within the three content areas yielding 13 second order orthogonal factors of AS problem themes which included work discrimination, and relationship difficulties with physicians. Significant findings were found for health ratings and second order factors uncontrollability' and stress'ratings of health status associated with lower levels of uncontrollability' and `stress'. No significant results were found for social support and second order factors. The validity and reliability of the IPAS are suggested for future study, and current findings must be interpreted cautiously. Further research is recommended.