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急性心肌梗死后患者康复目标的性别差异。

Gender differences in recovery goals in patients after acute myocardial infarction.

机构信息

Department of Applied Social Sciences, Leipzig University of Applied Sciences, Germany.

出版信息

J Cardiopulm Rehabil Prev. 2011 May-Jun;31(3):164-72. doi: 10.1097/HCR.0b013e31820333c8.

Abstract

PURPOSE

: While cardiac rehabilitation has been established as an essential part of comprehensive cardiac care, participation rates for female patients are substantially lower than for male patients. Lower referral rates and higher ages of female patients partly explain this underutilization. Gender differences in recovery goals of cardiac patients have not been examined.

METHODS

: Five hundred ninety patients (22.2% women) admitted to the hospital because of an acute myocardial infarction answered a questionnaire regarding 24 goals in 5 domains of recovery (physical functioning, risk-factor modification, psychological well-being, independence in daily life, and return to work). In addition, psychological symptoms and medical data were assessed. Gender differences were tested by using χ and Student t tests, as well as multivariate logistic and linear regression models.

RESULTS

: Gender differences were found in 7 of the 24 recovery goals. After adjustment for psychosocial and clinical characteristics, women still reported a higher importance of "performance of household duties" (odds ratio [OR] = 8.62; 95% confidence interval [CI], 5.43-13.66), "independence in activities of daily living" (OR = 2.38; CI, 1.58-3.59), and "emotional equilibrium" (OR = 1.58, CI, 1.01-2.46). Men rated "physical endurance" and "reducing strain at workplace" as more important goals (OR = 0.64; CI, 0.42-0.97 and OR = 0.39; CI, 0.17-0.93). Except for psychological distress, gender differences in health status were not related to differences in goals.

CONCLUSIONS

: Gender roles and differences in social-life conditions may have an important influence on the recovery goals of patients after an acute myocardial infarction. Recovery goals should be explored when planning intervention programs for individual patients.

摘要

目的

尽管心脏康复已被确立为综合心脏治疗的重要组成部分,但女性患者的参与率明显低于男性患者。较低的转诊率和女性患者较高的年龄部分解释了这种利用不足。心脏患者康复目标的性别差异尚未得到检验。

方法

590 名因急性心肌梗死住院的患者(22.2%为女性)回答了一份关于 5 个康复领域(身体功能、危险因素修正、心理幸福感、日常生活独立性和重返工作)的 24 个目标的问卷。此外,还评估了心理症状和医学数据。使用 χ 和 Student t 检验以及多元逻辑回归和线性回归模型测试了性别差异。

结果

在 24 个康复目标中有 7 个存在性别差异。在调整了社会心理和临床特征后,女性仍然报告了更高的“家务劳动能力”(比值比[OR] = 8.62;95%置信区间[CI],5.43-13.66)、“日常生活活动独立性”(OR = 2.38;CI,1.58-3.59)和“情绪平衡”(OR = 1.58,CI,1.01-2.46)的重要性更高。男性认为“体力耐力”和“减少工作场所压力”更为重要(OR = 0.64;CI,0.42-0.97 和 OR = 0.39;CI,0.17-0.93)。除了心理困扰外,健康状况的性别差异与目标差异无关。

结论

性别角色和社会生活条件的差异可能对急性心肌梗死后患者的康复目标产生重要影响。在为个别患者制定干预计划时,应探讨康复目标。

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