Faculty of Health, Kinesiology & Health Science, York University, Toronto, Ontario, Canada.
Anxiety Stress Coping. 2011 Jul;24(4):463-75. doi: 10.1080/10615806.2010.546838.
Psychosocial factors are increasingly recognized as risk indicators for coronary artery disease (CAD) prognosis and they are likely interrelated. The objective of this study is to simultaneously test the relationship between key psychosocial constructs as independent factor scores and recurrent events in CAD patients. There were 1268 CAD outpatients of 97 cardiologists surveyed at two points. Recurrent events or hospitalization in the intervening nine months were reported. Factor analysis of items from the Hospital Anxiety and Depression Scale, Perceived Stress Scale, the ENRICHD Social Support Inventory, and Hostile Attitudes Scale was performed to generate orthogonal factor scores. With adjustment for prognostic variables, logistic regression analysis was performed to examine the relationship between these factor scores and recurrent events. Factor analysis resulted in a six-factor solution: hostility, stress, anxiety, depressive symptoms, support, and resilience. Logistic regression revealed that functional status and anxiety, with a trend for depressive symptoms, were related to experiencing a recurrent event. In this simultaneous test of psychosocial constructs hypothesized to relate to cardiac prognosis, anxiety may be a particularly hazardous psychosocial factor. While replication is warranted, efforts to investigate the potential benefits of screening and to investigate treatments are needed.
心理社会因素正日益被视为冠心病（CAD）预后的风险指标，而且它们可能相互关联。本研究的目的是同时检验关键心理社会结构作为独立因素分数与 CAD 患者复发事件之间的关系。对 97 位心脏病专家的 1268 位 CAD 门诊患者在两个时间点进行了调查。报告了间隔九个月内的复发事件或住院情况。对医院焦虑和抑郁量表、感知压力量表、ENRICHD 社会支持量表和敌意态度量表中的项目进行因子分析，以生成正交因子分数。对预后变量进行调整后，进行逻辑回归分析以检验这些因子分数与复发事件之间的关系。因子分析得出了六因子解决方案：敌意、压力、焦虑、抑郁症状、支持和韧性。逻辑回归显示，功能状态和焦虑（抑郁症状有趋势）与经历复发事件有关。在对假设与心脏预后相关的心理社会结构的同时检验中，焦虑可能是一个特别危险的心理社会因素。虽然需要进行复制，但需要努力调查筛查的潜在益处，并调查治疗方法。
