Scheier M F, Matthews K A, Owens J F, Schulz R, Bridges M W, Magovern G J, Carver C S
Department of Psychology, Carnegie Mellon University, Pittsburgh, PA 15213, USA.
Arch Intern Med. 1999 Apr 26;159(8):829-35. doi: 10.1001/archinte.159.8.829.
To determine whether optimism predicts lower rates of rehospitalization after coronary artery bypass graft surgery for the 6 months after surgery.
A prospective, inception cohort design was used. The sample consisted of all consenting patients (N=309) from a consecutive series of patients scheduled for elective coronary artery bypass graft surgery at a large, metropolitan hospital in Pittsburgh, Pa. To be eligible, patients could not be scheduled for any other coincidental surgery (eg, valve replacement) and could not be in the cardiac intensive care unit or experiencing angina at the time of the referral. Participants were predominantly men (69.9%) and married (80.3%), and averaged 62.8 years of age. Recruitment occurred between January 1992 and January 1994.
Compared with pessimistic persons, optimistic persons were significantly less likely to be rehospitalized for a broad range of aggregated problems (including postsurgical sternal wound infection, angina, myocardial infarction, and the need for another bypass surgery or percutaneous transluminal coronary angioplasty) generally indicative of a poor response to the initial surgery (odds ratio=0.50, 95% confidence interval=0.33- 0.76; P=.001). The effect of optimism was independent of traditional sociodemographic and medical control variables, as well as independent of the effects of self-esteem, depression, and neuroticism. All-cause rehospitalization also tended to be less frequent for optimistic than for pessimistic persons (odds ratio=0.77, 95% confidence interval=0.57-1.05; P=.07).
Optimism predicts a lower rate of rehospitalization after coronary artery bypass graft surgery. Fostering positive expectations may promote better recovery.
确定乐观情绪是否能预测冠状动脉搭桥手术后6个月内再次住院率较低。
采用前瞻性队列研究设计。样本包括宾夕法尼亚州匹兹堡市一家大型都市医院连续系列择期冠状动脉搭桥手术患者中所有同意参与的患者（N = 309）。符合条件的患者不能安排进行任何其他同期手术（如瓣膜置换），且在转诊时不能处于心脏重症监护病房或正在经历心绞痛。参与者主要为男性（69.9%）且已婚（80.3%），平均年龄62.8岁。招募时间为1992年1月至1994年1月。
与悲观者相比，乐观者因一系列广泛的综合问题（包括术后胸骨伤口感染、心绞痛、心肌梗死以及需要再次进行搭桥手术或经皮冠状动脉腔内血管成形术）而再次住院的可能性显著降低，这些问题通常表明对初次手术反应不佳（比值比 = 0.50，95%置信区间 = 0.33 - 0.76；P = 0.001）。乐观情绪的影响独立于传统的社会人口统计学和医学控制变量，也独立于自尊、抑郁和神经质的影响。乐观者的全因再次住院率也往往低于悲观者（比值比 = 0.77，95%置信区间 = 0.57 - 1.05；P = 0.07）。
乐观情绪可预测冠状动脉搭桥手术后较低的再次住院率。培养积极的期望可能促进更好的康复。
