Helgeson V S, Fritz H L
Psychology Department, Carnegie Mellon University, Pittsburgh, PA 15213, USA. vh2e+@andrew.cmu.edu
Psychosom Med. 1999 Jul-Aug;61(4):488-95. doi: 10.1097/00006842-199907000-00013.
We tested whether the psychological components of cognitive adaptation theory would predict new coronary events after a first percutaneous transluminal coronary angioplasty (PTCA).
A consecutive sample of patients treated successfully with PTCA were enrolled in the study. Of 343 patients approached, 303 (88%) agreed to participate and were interviewed shortly before hospital discharge. We measured the components of cognitive adaptation theory (optimism, self-esteem, and mastery) during the interview. Five patients were excluded from the analysis because of early, in-hospital reocclusion. New cardiac events (coronary artery bypass grafting, PTCA, myocardial infarction, or disease progression) were examined within 6 months of the first PTCA. We obtained 6-month follow-up data on 98% of patients.
The cognitive adaptation index predicted new cardiac events, even when demographic variables and medical variables thought to predict restenosis were statistically controlled (p = .02).
These results suggest that persons who respond to their illness by perceiving control over their futures, by having positive expectations about their futures, and by holding a positive view of themselves seem to be at less risk for a new cardiac event after a first PTCA.
我们测试了认知适应理论的心理成分是否能预测首次经皮腔内冠状动脉成形术（PTCA）后的新发冠状动脉事件。
连续选取成功接受PTCA治疗的患者作为研究样本。在343名被邀请的患者中，303名（88%）同意参与研究，并在出院前不久接受了访谈。我们在访谈期间测量了认知适应理论的各个成分（乐观、自尊和掌控感）。5名患者因早期院内再闭塞被排除在分析之外。在首次PTCA后的6个月内检查新发心脏事件（冠状动脉旁路移植术、PTCA、心肌梗死或疾病进展）。我们获得了98%患者的6个月随访数据。
即使在对认为可预测再狭窄的人口统计学变量和医学变量进行统计学控制后，认知适应指数仍能预测新发心脏事件（p = 0.02）。
这些结果表明，那些通过感知对未来的掌控、对未来持有积极期望以及对自己持有积极看法来应对疾病的人，在首次PTCA后发生新发心脏事件的风险似乎较低。
