Pfaff Kathryn A, El-Masri Maher M, Fox-Wasylyshyn Susan M
University of Windsor, Faculty of Nursing, 401 Sunset, Health Education Center, Windsor, Ontario, N9B 3P4.
Can J Cardiovasc Nurs. 2009;19(4):26-32.
Stress is an untoward condition in patients with acute myocardial infarction (AMI). Abrupt nicotine withdrawal is associated with increased symptoms of stress. However, little is known about the impact of smoking cessation on the psychological indicators of stress among hospitalized AMI patients.
In this pilot study we compared the psychological stressors between non-smoking AMI patients and smoking patients who abruptly ceased smoking following admission to the CCU.
A cross-sectional survey was piloted on a sample of 57 AMI patients (29 smokers and 28 nonsmokers) on the second day of admission to the CCU. Psychological stress was measured using the Profile of Mood States and the Insomnia Severity Index.
Multivariate analysis of covariance (MANCOVA) suggested that after adjusting for age, smokers experienced significantly higher overall levels of stress than non-smokers (F = 3.13; p = 0.016). Post-hoc analyses suggested that scores of depression (p = 0.033), anxiety (p = 0.007), and anger (p = 0.017) were particularly higher among smokers, as compared to non-smokers. However, the two groups were not different with regard to their scores on fatigue (p = 0.528) and insomnia (p = 0.299).
Abrupt smoking cessation may expose patients admitted with AMI symptoms to higher levels of psychological stress. Given the potential damaging impact of psychological stressors on the physical outcomes of these patients, these findings demonstrate the need for continued assessment and research related to the management of nicotine withdrawal following AMI.
压力是急性心肌梗死(AMI)患者的一种不良状况。突然戒烟与压力症状增加有关。然而,关于戒烟对住院AMI患者压力心理指标的影响知之甚少。
在这项初步研究中,我们比较了非吸烟AMI患者与入住冠心病监护病房(CCU)后突然戒烟的吸烟患者之间的心理压力源。
在CCU入院第二天,对57例AMI患者(29例吸烟者和28例非吸烟者)进行了横断面调查。使用情绪状态量表和失眠严重程度指数测量心理压力。
多变量协方差分析(MANCOVA)表明,在调整年龄后,吸烟者的总体压力水平显著高于非吸烟者(F = 3.13;p = 0.016)。事后分析表明,与非吸烟者相比,吸烟者的抑郁(p = 0.033)、焦虑(p = 0.007)和愤怒(p = 0.017)得分尤其更高。然而,两组在疲劳(p = 0.528)和失眠(p = 0.299)得分方面没有差异。
突然戒烟可能会使有AMI症状的患者面临更高水平的心理压力。鉴于心理压力源对这些患者身体状况的潜在破坏性影响,这些发现表明需要对AMI后戒烟管理进行持续评估和研究。