Broadbent Elizabeth, Ellis Chris J, Thomas Janine, Gamble Greg, Petrie Keith J
Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
J Psychosom Res. 2009 Jul;67(1):11-5. doi: 10.1016/j.jpsychores.2008.11.006. Epub 2009 Mar 3.
To investigate whether a brief in-hospital illness perception intervention for myocardial infarction (MI) patients and their spouses could change spouses' illness perceptions and reduce spouses' anxiety about the illness.
Fifty-seven spouses participated in a randomized controlled trial of an illness perception intervention for MI patients. Spouses of patients randomized to the intervention attended one half-hour patient-and-spouse session with a psychologist in addition to standard care. Spouses completed measures of illness perceptions, expectations, and illness anxiety at admission and at 1 week following discharge, and spouses' illness worry was rated by the patients at 3 months. The main outcome for spouses was differences in anxiety between intervention and control groups.
One week following discharge, spouses in the intervention group had higher illness understanding, lower concern, stronger causal attributions to hereditary factors, and fewer questions about their partner's heart condition compared to the control group. Intervention group spouses reported more positive expectations about the ability of the patient's heart to recover, and lower perceived likelihood of another MI. They had lower anxiety about the patient doing physical activity and about the patient's medications, and lower distress about the patient's symptoms. Spouses in the intervention group were rated as less worried about the illness at 3 months.
Spouses of patients represent a new target for illness perception interventions and these results demonstrate that a brief illness perception intervention can change illness perceptions and reduce anxiety about the illness in spouses of MI patients.
探讨对心肌梗死(MI)患者及其配偶进行简短的住院期间疾病认知干预是否能改变配偶的疾病认知并减轻其对疾病的焦虑。
57名配偶参与了一项针对MI患者疾病认知干预的随机对照试验。随机分配至干预组的患者配偶除接受标准护理外,还与一名心理学家共同参加一次半小时的患者及配偶会议。配偶在入院时和出院后1周完成疾病认知、期望和疾病焦虑的测量,患者在3个月时对配偶的疾病担忧进行评分。配偶的主要结局是干预组和对照组之间焦虑的差异。
出院后1周,与对照组相比,干预组的配偶对疾病有更高的理解、更低的担忧、对遗传因素更强的因果归因,以及对其伴侣心脏状况的疑问更少。干预组的配偶对患者心脏恢复能力报告了更积极的期望,以及更低的再次发生心肌梗死的感知可能性。他们对患者进行体育活动和用药的焦虑更低,对患者症状的困扰也更低。干预组的配偶在3个月时被评为对疾病的担忧更少。
患者的配偶是疾病认知干预的新目标,这些结果表明,简短的疾病认知干预可以改变疾病认知并减轻MI患者配偶对疾病的焦虑。