Abstract
BackgroundThe concept of a rational respectively emotional acceptance of disease is highly valued in the treatment of patients with depression or addiction. Due to the importance of this concept for the long-term course of disease, there is a strong interest to develop a tool to identify the levels and factors of acceptance. We thus intended to test an instrument designed to assess the level of positive psychological wellbeing and coping, particularly emotional disease acceptance and life satisfactionMethodsIn an anonymous cross-sectional survey enrolling 115 patients (51% female, 49% male; mean age 47.6 ± 10.0 years) with depression and/or alcohol addiction, the ERDA questionnaire was tested.ResultsFactor analysis of the 29-item construct (Cronbach's alpha = 0.933) revealed a 4-factor solution, which explained 59.4% of variance: (1) Positive Life Construction, Contentedness and Well-Being; (2) Conscious Dealing with Illness; (3) Rejection of an Irrational Dealing with Disease; (4) Disease Acceptance. Two factors could be ascribed to a rational, and two to an emotional acceptance. All factors correlated negatively with Depression and Escape, while several aspects of Life Satisfaction" (i.e. myself, overall life, where I live, and future prospects) correlated positively. The highest factor scores were found for the rational acceptance styles (i.e. Conscious Dealing with Illness; Disease Acceptance). Emotional acceptance styles were not valued in a state of depression. Escape from illness was the strongest predictor for several acceptance aspects, while life satisfaction was the most relevant predictor for "Positive Life Construction, Contentedness and Well-Being".ConclusionThe ERDA questionnaire was found to be a reliable and valid assessment of disease acceptance strategies in patients with depressive disorders and drug abuses. The results indicate the preferential use of rational acceptance styles even in depression. Disease acceptance should not be regarded as a coping style with an attitude of fatalistic resignation, but as a complex and active process of dealing with a chronic disease. One may assume that an emotional acceptance of disease will result in a therapeutic coping process associated with higher level of life satisfaction and overall quality of life.
Highlights
The concept of a rational respectively emotional acceptance of disease is highly valued in the treatment of patients with depression or addiction
The results indicate the preferential use of rational acceptance styles even in depression
Disease acceptance should not be regarded as a coping style with an attitude of fatalistic resignation, but as a complex and active process of dealing with a chronic disease
Summary
The concept of a rational respectively emotional acceptance of disease is highly valued in the treatment of patients with depression or addiction. Carver et al [2] found 15 factors that reflect active versus avoidant coping strategies, among them "Resignation/ Acceptance" (accepting the fact that the stressful event has occurred and is real) and "Focus on and Venting of Emotions" (increased awareness of one's emotional distress, and concomitant tendency to ventilate or discharge those feelings). Avoidant strategies are intended to prevent a direct confrontation with the stressful events, and may often result in inappropriate activities such as alcohol abuse or depressive states. These avoidance strategies were identified as psychological risk factors or marker for adverse responses to stressful life events [3]. Lung transplant candidates most likely use active, acceptance, and support-seeking strategies to cope with health problems, while self-blame or avoidance were rarely used [5]; the avoidant coping was the most strongly and consistently related to quality of life
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