Suzuki Shoji, Takaki Hiroshi, Yasumura Yoshio, Sakuragi Satoru, Takagi Shuichi, Tsutsumi Yoshiaki, Aihara Naohiko, Sakamaki Fumio, Goto Yoichi
Division of Cardiology, National Cardiovascular Center, Suita, Japan.
Circ J. 2005 Dec;69(12):1527-34. doi: 10.1253/circj.69.1527.
Measures assessing quality of life (QOL) in patients participating in comprehensive cardiac rehabilitation (CCR) have not been established in Japan.
To compare different types of QOL scales and to determine the impact of CCR on QOL in Japanese cardiac patients, 5 different types of questionnaires were assessed in 44 patients participating in CCR after acute myocardial infarction (AMI). After 3-month CCR, peak oxygen uptake (PVO2, p<0.01), Sickness Impact Profile (SIP) total score (p<0.05) and physical function-related QOL scores (Specific Activity Scale (SAS), p<0.01; SIP physical score, p<0.01) significantly improved, whereas psychosocial/mental aspect-related QOL scores (Ministry of Health and Welfare (MHW)-QOL score, SIP psychosocial score, State-Trait Anxiety Inventory, Self-rating Depression Scale) did not change on the average. However, patients with low PVO2 (<21.7 ml.min-1.kg-1) showed significant improvements in all scores after CCR, whereas patients with preserved exercise capacity showed improvements only in physical function-related scores (SAS and physical SIP). Furthermore, patients with anxiety and depression showed significant improvements in these respective measures after CCR.
In patients with AMI, physical function-related QOL scores improve after a 3-month CCR program, but psychosocial/mental aspect-related QOL scores improve only in those with impaired exercise tolerance or anxiety/depression. Thus, changes in QOL after CCR depend on type of QOL scale used and the baseline status of the patient. In addition, in Japanese cardiac patients MHW-QOL mainly reflects psychosocial/mental aspect-related QOL, as well as overall QOL.
在日本，尚未确立用于评估参与综合心脏康复（CCR）患者生活质量（QOL）的指标。
为比较不同类型的生活质量量表，并确定CCR对日本心脏病患者生活质量的影响，对44例急性心肌梗死（AMI）后参与CCR的患者评估了5种不同类型的问卷。经过3个月的CCR后，峰值摄氧量（PVO2，p<0.01）、疾病影响量表（SIP）总分（p<0.05）以及与身体功能相关的生活质量评分（特定活动量表（SAS），p<0.01；SIP身体评分，p<0.01）显著改善，而社会心理/精神方面相关的生活质量评分（厚生省（MHW）-生活质量评分、SIP社会心理评分、状态-特质焦虑量表、自评抑郁量表）平均未发生变化。然而，PVO2较低（<21.7 ml.min-1.kg-1）的患者在CCR后所有评分均有显著改善，而运动能力保留的患者仅在与身体功能相关的评分（SAS和身体SIP）上有所改善。此外，伴有焦虑和抑郁的患者在CCR后这些相应指标上有显著改善。
在AMI患者中，经过3个月的CCR项目后，与身体功能相关的生活质量评分有所改善，但社会心理/精神方面相关的生活质量评分仅在运动耐量受损或伴有焦虑/抑郁的患者中得到改善。因此，CCR后生活质量的变化取决于所使用的生活质量量表类型以及患者的基线状态。此外，在日本心脏病患者中，MHW-生活质量主要反映社会心理/精神方面相关的生活质量以及总体生活质量。
