Brummett Beverly H, Babyak Michael A, Mark Daniel B, Clapp-Channing Nancy E, Siegler Ilene C, Barefoot John C
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
Ann Behav Med. 2004 Feb;27(1):22-30. doi: 10.1207/s15324796abm2701_4.
Psychological stress is known to have a negative effect on the health and well-being of coronary artery disease (CAD) patients. Although the study of stress CAD samples has received considerable attention, few studies have examined the effects of gender and age, had multiple follow-ups over an extended period, and had extensive baseline assessment batteries.
In this study, demographic, clinical, social, and personality variables were evaluated as predictors of nine repeated assessments of stress over a 2-year period in 322 CAD patients (33.2% female).
At baseline, perceived social support, coping style, and social conflict were associated with stress ratings. Mixed models were used to evaluate predictors of reported stress during the subsequent 2 years.
The results showed that higher stress was present in patients who were female and young. Follow-up stress was also found in patients with moderate income, congestive heart failure, high social conflict, low social support, and negative coping style.
These findings may help clinicians identify patients who are likely to experience higher levels of stress over a prolonged period following a diagnosis of CAD and may also suggest which patients may benefit most from stress reduction interventions.
众所周知，心理压力会对冠状动脉疾病（CAD）患者的健康和幸福产生负面影响。尽管对压力性CAD样本的研究受到了相当多的关注，但很少有研究考察性别和年龄的影响，在较长时期内进行多次随访，以及拥有广泛的基线评估量表。
在本研究中，对322例CAD患者（女性占33.2%）在2年期间进行的9次重复压力评估的预测因素进行了人口统计学、临床、社会和人格变量评估。
在基线时，感知到的社会支持、应对方式和社会冲突与压力评分相关。使用混合模型评估后续2年报告压力的预测因素。
结果显示，女性和年轻患者的压力更高。中等收入、充血性心力衰竭、高社会冲突、低社会支持和消极应对方式的患者在随访中也存在压力。
这些发现可能有助于临床医生识别出在CAD诊断后较长时期内可能经历更高水平压力的患者，也可能提示哪些患者可能从减压干预中获益最大。
