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Commonalities and Differences in Psychological Adjustment to Chronic Illnesses Among Older Adults: a Comparative Study Based on the Stress and Coping Paradigm

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Abstract

Background

This study aimed to validate the role of the stress and coping paradigm in the context of psychological adjustment to chronic illnesses among older adults by using the structural equation modeling technique, as well as investigating the differences in structural weights between older adults with arthritis and older adults with hypertension.

Method

A cross-sectional study was conducted with 325 older adults with chronic illnesses (149 hypertension, 176 arthritis), aged 60–88 years, who completed questions on perceived social support, psychological resources, threat appraisal, self-efficacy, coping strategy, depressive symptoms, and anxiety.

Results

The results revealed that older adults with arthritis experienced significantly higher anxiety (t = 2.91, p < 0.01) than those with hypertension, whereas no significant difference in their depressive symptoms was observed (t = 1.61, p > 0.05). Social support, psychological resources, threat appraisal, and self-efficacy had a significant direct relationship with psychological distress (β = − 0.15, β = − 0.38, β = 0.19, β = − 0.23, respectively). Multi-group analyses showed significant differences in structural weights between older adults with hypertension and those with arthritis (Δχ2 = 41.336, Δdf = 18, p < 0.01).

Conclusion

The stress and coping paradigm appears to be applicable for adjustment to chronic illnesses by allowing direct paths from social support, psychological resources, threat appraisal, and self-efficacy to psychological distress. The differences in structural weights may offer an intervening angle for clinical practitioners to design targeted interventions for older adults with different types of chronic illnesses.

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Notes

  1. In this study, we used the single Cognitive Adaptation Index as the indicator of psychological resources instead of building a latent variable; the main reason is that this index can comprehensively reflect a series of mildly positive self-relevant distortions and can successfully promote the adjustment to chronic illness (Taylor 1983; Stanton, Revenson, Tennen 2007). Helgeson (1999, 2003) created the single index by standardizing each of the three variables and confirmed this composite index is generally more reliable than single scales. In addition, we also created and tested a latent modeling, in which optimism, perceived control, and self-esteem as endogenous latent variables for psychological resources. However, the fit indices for the SEM model were unsatisfactory in this study.

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Acknowledgments

We thank Dr. Ursula Staudinger for her valuable insight and suggestions, and Jiamei Li for her commentary on the revised manuscript.

Funding

This work was supported by the National Social Science Fund of China (16BSH101).

Author information

Authors and Affiliations

  1. Centre for Mental Health Education, Faculty of Psychology, Southwest University, Beibei, Chongqing, 400715, China

    Jingjin Shao, Hang Yang, Weiping Du & Huijie Lei

  2. Department of Tourism and Art for Humanity, Chongqing Youth Vocational & Technical College, Chongqing, China

    Qinghua Zhang

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  1. Jingjin Shao
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Correspondence to Jingjin Shao.

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The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Shao, J., Yang, H., Zhang, Q. et al. Commonalities and Differences in Psychological Adjustment to Chronic Illnesses Among Older Adults: a Comparative Study Based on the Stress and Coping Paradigm. Int.J. Behav. Med. 26, 143–153 (2019). https://doi.org/10.1007/s12529-019-09773-8

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  • DOI: https://doi.org/10.1007/s12529-019-09773-8

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