Bean Melanie K, Gibson Douglas, Flattery Maureen, Duncan Angela, Hess Michael
Department of Pediatrics and Psychology, Virginia Commonwealth University, Richmond, VA 23298-0440, USA.
Prog Cardiovasc Nurs. 2009 Dec;24(4):131-40. doi: 10.1111/j.1751-7117.2009.00051.x.
Advances in treatment have prolonged life in heart failure (HF) patients, leading to increased attention to quality of life (QOL) and psychological functioning. It is not clear if ethnic differences exist in factors associated with psychological well-being. We examined psychosocial factors associated with depression and anxiety in 97 HF patients. Medical records were reviewed and patients (M age 53, 50% African American) completed surveys examining social support, coping, spirituality, and QOL for their association with depression and anxiety. Multiple regressions suggested that psychosocial factors were associated with psychological health. Patients with lower social support, lower meaning/peace and more negative coping reported greater depression; positive coping, and lower meaning/peace were associated with higher anxiety. Ethnicity stratified models suggested that spiritual well-being was associated with depression only among African Americans and QOL partially mediated this relationship. Findings suggest the importance of considering the unique psychosocial needs of diverse populations to appropriately target clinical interventions.
治疗方法的进步延长了心力衰竭（HF）患者的生命，这使得人们对生活质量（QOL）和心理功能的关注度不断提高。目前尚不清楚在与心理健康相关的因素方面是否存在种族差异。我们对97名HF患者中与抑郁和焦虑相关的心理社会因素进行了研究。我们查阅了病历，患者（平均年龄53岁，50%为非裔美国人）完成了相关调查，以检验社会支持、应对方式、精神信仰和生活质量与抑郁和焦虑之间的关联。多元回归分析表明，心理社会因素与心理健康相关。社会支持较低、意义/平静感较低且消极应对较多的患者报告的抑郁程度更高；积极应对以及较低的意义/平静感与较高的焦虑相关。按种族分层的模型表明，精神健康仅在非裔美国人中与抑郁相关，生活质量部分介导了这种关系。研究结果表明，考虑不同人群独特的心理社会需求对于合理确定临床干预目标非常重要。
