Georgia Baptist College of Nursing, Mercer University, Atlanta, Georgia, USA.
J Adv Nurs. 2011 May;67(5):1000-11. doi: 10.1111/j.1365-2648.2010.05564.x. Epub 2011 Feb 24.
This paper reports findings of a study to examine the independent contribution of chest pain, fatigue and dyspnoea to health-related quality of life in people with chronic stable angina.
People with chronic stable angina experience poorer quality of life in multiple areas including physical and emotional health. Emerging evidence suggests the presence of concomitant symptoms yet there are no systematic studies examining the impact of symptom clusters on quality of life in people with chronic angina.
Outpatients (n = 134), recruited over a 16-month period in 2000 and 2001, with confirmed coronary heart disease and chronic angina completed reliable and valid questionnaires measuring chest pain frequency, fatigue, dyspnoea and quality of life. The data have contemporary relevance because despite changes in treatment of coronary heart disease, chronic angina remains prevalent worldwide. Hierarchical multiple linear regression was used to examine the symptom cluster of chest pain frequency, fatigue and dyspnoea in predicting quality of life.
The sample was predominantly white (74·6%), men (59·7%) with a mean age of 63·4 (sd 12·12) years. Controlling for age, gender, social status and co-morbidities, the symptom cluster of chest pain frequency, dyspnoea and fatigue accounted for a statistically significant increase in unadjusted R² (F of Δ, P < 0·05) for the models predicting physical limitation (R² Δ 24·1%), disease perception (R² Δ 24·6%), Short Form-36 Physical Component Score (R² Δ 24·3%) and Mental Component Score (R² Δ 07·0%).
Symptom assessment and management of people with chronic stable angina should involve multiple symptoms. Greater fatigue predicted poorer quality of life in multiple areas. As a possible indicator of depression, it warrants further assessment and follow-up.
本研究旨在考察胸痛、疲劳和呼吸困难对慢性稳定性心绞痛患者健康相关生活质量的独立影响。
慢性稳定性心绞痛患者在多个领域（包括身体和情绪健康）的生活质量较差。新出现的证据表明，同时存在伴随症状，但目前尚无系统研究检查慢性稳定性心绞痛患者的症状群对生活质量的影响。
2000 年至 2001 年的 16 个月期间，招募了 134 名经证实患有冠心病和慢性稳定型心绞痛的门诊患者，他们完成了可靠和有效的问卷，以测量胸痛频率、疲劳、呼吸困难和生活质量。尽管冠心病的治疗发生了变化，但慢性稳定型心绞痛在全球仍很普遍，因此该数据具有现代相关性。使用分层多元线性回归来检查胸痛频率、疲劳和呼吸困难的症状群在预测生活质量方面的作用。
该样本主要为白人（74.6%），男性（59.7%），平均年龄为 63.4（标准差 12.12）岁。在控制年龄、性别、社会地位和合并症后，胸痛频率、呼吸困难和疲劳的症状群在预测身体受限（调整后 R² 的 F 增量，P < 0.05）、疾病认知（调整后 R² 的 F 增量，P < 0.05）、健康调查简表 36 项躯体成分评分（调整后 R² 的 F 增量，P < 0.05）和精神成分评分（调整后 R² 的 F 增量，P < 0.05）的模型中，显著增加了未调整的 R²。
对慢性稳定性心绞痛患者的症状评估和管理应包括多种症状。疲劳程度增加预示着多个领域的生活质量下降。作为抑郁的一个可能指标，它需要进一步评估和随访。
