Franche Renée-Louise, Abbey Susan, Irvine Jane, Shnek Zachary M, Grace Sherry L, Devins Gerald M, Stewart Donna E
Institute for Work & Health Network, University of Toronto, ON, Canada.
J Psychosom Res. 2004 Jan;56(1):125-32. doi: 10.1016/S0022-3999(03)00505-1.
OBJECTIVE: This prospective study examined sex differences in illness intrusiveness and in baseline predictors of illness intrusiveness in cardiac patients' 1-year postcardiac event. METHODS: Patients diagnosed with a myocardial infarction (MI) or unstable angina (UA) completed a baseline questionnaire during their hospitalization (139 men and 104 women). Eighty-one men and 67 women completed the follow-up questionnaire 1-year postcardiac event. The questionnaire included measures of illness intrusiveness in three life domains, depressive symptomatology, social support, medical information, risk factors for heart disease, and sociodemographic information. RESULTS: A MANCOVA with the three Illness Intrusiveness subscales as dependent variables, sex as the between-group factor, and partnership status as a covariate found a sex effect for the Intimacy subscale, but not for the Instrumental and the Relationships/Personal Development subscales. Men reported more intrusiveness in the Intimacy domain of their life as compared to women. After controlling for sociodemographic factors and risk factors for heart disease, hierarchical regressions indicated sex differences in baseline predictors of 1-year follow-up illness intrusiveness in the three life domains. For men, being satisfied with support from partner at baseline was associated with less intrusiveness in the Instrumental Life domain 1 year after the cardiac event. For women, surprisingly, more satisfaction with support from their partner at baseline was associated with more intrusiveness in their intimate lives 1 year after their cardiac event. In addition, emotional symptoms of depression at baseline were predictive of increased illness intrusiveness in Relationship/Personal Development and Intimacy domains for men and in Instrumental and Intimacy domains for women. CONCLUSION: Support from partner may have a differential impact for men and women after a cardiac event. Depressive symptomatology during initial hospitalization, particularly emotional symptoms, is a prominent indicator of illness intrusiveness for both sexes 1 year after the cardiac event.
目的：本前瞻性研究调查了心脏病患者心脏事件发生1年后疾病侵扰方面的性别差异以及疾病侵扰的基线预测因素。 方法：诊断为心肌梗死（MI）或不稳定型心绞痛（UA）的患者在住院期间完成了一份基线调查问卷（139名男性和104名女性）。81名男性和67名女性在心脏事件发生1年后完成了随访调查问卷。该问卷包括三个生活领域的疾病侵扰测量、抑郁症状、社会支持、医疗信息、心脏病风险因素以及社会人口统计学信息。 结果：以三个疾病侵扰分量表为因变量、性别为组间因素、伴侣状态为协变量的多变量协方差分析发现，亲密关系分量表存在性别效应，但工具性和关系/个人发展分量表不存在性别效应。与女性相比，男性报告其生活的亲密关系领域受到的侵扰更多。在控制了社会人口统计学因素和心脏病风险因素后，分层回归表明，在三个生活领域中，1年随访疾病侵扰的基线预测因素存在性别差异。对于男性来说，基线时对伴侣支持感到满意与心脏事件发生1年后工具性生活领域受到的侵扰较少有关。令人惊讶的是，对于女性来说，基线时对伴侣支持更满意与心脏事件发生1年后其亲密生活受到的侵扰更多有关。此外，基线时的抑郁情绪症状可预测男性在关系/个人发展和亲密关系领域以及女性在工具性和亲密关系领域疾病侵扰的增加。 结论：心脏事件发生后，伴侣的支持对男性和女性可能有不同的影响。初次住院期间的抑郁症状，尤其是情绪症状，是心脏事件发生1年后两性疾病侵扰的一个突出指标。
J Psychosom Res. 2004-1
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