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不明原因胸痛的男性和女性的心理社会状况

Psychosocial profile in men and women with unexplained chest pain.

作者信息

Jerlock M, Kjellgren K I, Gaston-Johansson F, Lissner L, Manhem K, Rosengren A, Welin C

机构信息

Institute of Health and Care Sciences, the Sahlgrenska Academy, Gothenburg, Sweden.

出版信息

J Intern Med. 2008 Sep;264(3):265-74. doi: 10.1111/j.1365-2796.2008.01961.x. Epub 2008 Apr 4.

Abstract

OBJECTIVE

The aim of this study was to compare men and women with unexplained chest pain (UCP) to a randomly selected population sample free of clinical heart disease with regard to sleep problems, mental strain at work, stress at home, negative life events and health-related quality of life (HRQOL).

DESIGN AND SUBJECTS

The study was conducted at a university hospital in Sweden including 231 patients aged 25-69 without any organic cause for chest pain. As a reference group, 1069 participants, were recruited from the INTERGENE population-based study.

RESULTS

Patients with UCP had more sleep problems (OR = 1.8, P < 0.0001), were almost three times more worried about stress at work (OR = 2.9, P < 0.0001), or had more stress at home (OR = 2.8, P < 0.0001), and were twice as likely to have negative life events (OR = 2.1, P < 0.0001). Women, but not men, with UCP, had a higher prevalence of cardiovascular risk factors (obesity, smoking, diabetes and hypertension) compared with references. With regard to HRQOL, UCP patients scored significantly lower than references in all dimensions of the SF-36.

CONCLUSIONS

In comparison with a healthy reference group, patients with UCP reported more sleep problems, mental strain at work, stress at home and negative life events and had lower health-related quality of life. Aside from immigration the strongest independent psychosocial factors were mental strain at work and negative life events last year in men and stress at home in women.

摘要

目的

本研究旨在比较不明原因胸痛(UCP)的男性和女性与随机选取的无临床心脏病的人群样本在睡眠问题、工作中的精神压力、家庭压力、负面生活事件以及健康相关生活质量(HRQOL)方面的差异。

设计与研究对象

该研究在瑞典的一家大学医院进行,纳入了231名年龄在25 - 69岁之间且无任何胸痛器质性病因的患者。作为对照组,从基于人群的INTERGENE研究中招募了1069名参与者。

结果

UCP患者有更多的睡眠问题(比值比[OR]=1.8,P<0.0001),担心工作压力的可能性几乎是对照组的三倍(OR = 2.9,P<0.0001),或家庭压力更大(OR = 2.8,P<0.0001),发生负面生活事件的可能性是对照组的两倍(OR = 2.1,P<0.0001)。与对照组相比,UCP女性患者心血管危险因素(肥胖、吸烟、糖尿病和高血压)的患病率较高,而男性患者则不然。在HRQOL方面,UCP患者在SF - 36的所有维度上的得分均显著低于对照组。

结论

与健康对照组相比,UCP患者报告有更多的睡眠问题、工作中的精神压力、家庭压力和负面生活事件,且健康相关生活质量较低。除移民因素外,最强的独立社会心理因素在男性中是工作中的精神压力和去年的负面生活事件,在女性中是家庭压力。

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