Lett Heather S, Blumenthal James A, Babyak Michael A, Catellier Diane J, Carney Robert M, Berkman Lisa F, Burg Matthew M, Mitchell Pamela, Jaffe Allan S, Schneiderman Neil
Duke University Medical Center, Durham, NC 27710, USA.
Int J Behav Med. 2009;16(3):248-58. doi: 10.1007/s12529-009-9040-x.
There is considerable evidence that depression and low social support are associated with increased morbidity and mortality for patients with coronary heart disease (CHD). However, there is a lack of consensus regarding the measurement of social support and its relation to depression.
The primary purpose of the present study was to identify key dimensions of existing social support and depression measures for patients with CHD using factor analysis.
Seven hundred-five patients with a recent acute myocardial infarction and either depression, low social support, or both, completed measures of several types of social support and depression. Exploratory and confirmatory factor analysis were used to examine the underlying dimensions of the existing social support and depression measures, and to compare theoretically plausible models specifying the relation between the social support and depression factors.
Confirmatory factor analysis indicated that an approach in which smaller facets of depression are measured (somatic, cognitive/affective, anxious) and social support (perceived emotional support from intimate relationships; perceived tangible support from peripheral contacts; and the number of children, relatives, and friends in a patient's support network), may be the most optimal way to measure social support and depression in this population RMSEA = 0.05; CFI = 0.81; TLI = 0.88).
Efforts to identify patients at increased psychosocial risk may be improved by screening for these subcomponents of social support and depression.
有大量证据表明，抑郁症和社会支持不足与冠心病（CHD）患者的发病率和死亡率增加有关。然而，关于社会支持的测量及其与抑郁症的关系，目前尚无共识。
本研究的主要目的是通过因子分析确定冠心病患者现有社会支持和抑郁症测量方法的关键维度。
705名近期发生急性心肌梗死且患有抑郁症、社会支持不足或两者兼有的患者完成了几种社会支持和抑郁症类型的测量。探索性和验证性因子分析用于检验现有社会支持和抑郁症测量方法的潜在维度，并比较指定社会支持和抑郁症因子之间关系的理论上合理的模型。
验证性因子分析表明，一种测量抑郁症较小方面（躯体、认知/情感、焦虑）和社会支持（来自亲密关系的感知情感支持；来自外围联系人的感知实际支持；以及患者支持网络中的子女、亲属和朋友数量）的方法，可能是测量该人群社会支持和抑郁症的最佳方式（RMSEA = 0.05；CFI = 0.81；TLI = 0.88）。
通过筛查社会支持和抑郁症的这些子成分，识别心理社会风险增加患者的努力可能会得到改善。
