Deaton Christi, Kimble Laura P, Veledar Emir, Hartigan Pamela, Boden William E, O'Rourke Robert A, Weintraub William S
The University of Manchester, Manchester, United Kingdom.
Heart Lung. 2006 Sep-Oct;35(5):315-23. doi: 10.1016/j.hrtlng.2006.05.005.
Coronary heart disease (CHD) and diabetes may have synergistic effects on symptoms, self-management, and general and cardiac-specific health status.
We compared symptom distress, self-management difficulties, and general and cardiac-specific health status in patients with CHD by the presence and severity of diabetes.
We performed a cross-sectional study of 1013 patients enrolled in the COURAGE trial, with the use of clinical data, the Symptom Distress Scale, the Self-Management Difficulties Scale, the Short-Form 36, and the Seattle Angina Questionnaire.
Patients with diabetes and greater severity of diabetes had worse findings in symptom distress, self-management difficulties, and general and cardiac-specific health status than patients without diabetes.
A robust effect of diabetes on symptom distress and self-management difficulties was found in patients with CHD. The results from the Seattle Angina Questionnaire illustrate difficulty in attributing physical limitations to specific symptoms or conditions, and show the experience of comorbid conditions to be synergistic. Clinicians' understanding of this synergy and integration of condition-specific care with general treatment and self-management practices are needed.
冠心病（CHD）和糖尿病可能在症状、自我管理以及总体和心脏特异性健康状况方面产生协同作用。
我们根据糖尿病的存在情况和严重程度，比较了冠心病患者的症状困扰、自我管理困难以及总体和心脏特异性健康状况。
我们对参与“勇气”试验的1013名患者进行了横断面研究，使用了临床数据、症状困扰量表、自我管理困难量表、简短健康调查简表36以及西雅图心绞痛问卷。
与无糖尿病患者相比，患有糖尿病以及糖尿病病情更严重的患者在症状困扰、自我管理困难以及总体和心脏特异性健康状况方面的表现更差。
在冠心病患者中发现糖尿病对症状困扰和自我管理困难有显著影响。西雅图心绞痛问卷的结果表明，难以将身体限制归因于特定症状或疾病，并显示合并症的影响具有协同作用。临床医生需要了解这种协同作用，并将针对特定疾病的护理与一般治疗和自我管理实践相结合。
