Department of Psychological Medicine, University of Auckland, New Zealand.
Health Psychol. 2012 Nov;31(6):738-44. doi: 10.1037/a0026502. Epub 2011 Dec 12.
Coronary computed tomography (CT) angiography is an advanced cardiac imaging test commonly used for diagnosing early signs of ischemic heart disease. Despite its importance in cardiology, little is known about its psychological effect on patients. The present study sought to examine these effects in relation to illness perceptions, cardiac health behavior intentions, and subsequent health behaviors.
Forty-five nonacute cardiac patients who were referred for diagnostic coronary CT angiography completed questionnaires prior to testing and following the receipt of test results, at which point illness perceptions and intentions to take cardiac medication, as well as diet and exercise intentions were measured. Exercise and dietary behaviors were measured at follow-up 6 weeks later. Changes on these variables were then compared between patients diagnosed with normal arteries and patients diagnosed with diseased arteries.
Compared to positive-testing patients, patients with normal test results reported significant changes toward more positive illness perceptions following testing, with improvements in emotional effect of illness, illness concern, consequences, and personal control of illness. The illness perception of treatment control was seen as more important among positive-testing patients, whereas both groups reported increases in illness coherence. Health behavior intentions (cardiac medication intentions and exercise intentions) increased for positive-testing patients only, as did physical activity at follow-up.
Diagnosis-dependent psychological effects can be detected following coronary CT angiography. These effects have important implications for patient health and health care in diagnostic contexts, and the results from this study can be used to guide further research in this area.
冠状动脉计算机断层(CT)血管造影是一种常用于诊断缺血性心脏病早期迹象的先进心脏成像测试。尽管它在心脏病学中很重要,但对其对患者的心理影响知之甚少。本研究旨在研究这些影响与疾病认知、心脏健康行为意图以及随后的健康行为之间的关系。
45 名非急性心脏病患者在接受诊断性冠状动脉 CT 血管造影检查前和收到检查结果后完成了问卷调查,此时测量了疾病认知和服用心脏药物、饮食和运动意图。在 6 周后的随访中测量了运动和饮食行为。然后比较了被诊断为正常动脉和被诊断为患病动脉的患者在这些变量上的变化。
与阳性检测患者相比,检测结果正常的患者在检测后报告了对疾病认知的明显变化,朝着更积极的方向发展,包括疾病的情绪影响、疾病关注度、后果和对疾病的个人控制。阳性检测患者认为治疗控制的疾病认知更为重要,而两组患者均报告了疾病连贯性的提高。阳性检测患者的健康行为意图(心脏药物意图和运动意图)增加,随访时的身体活动也增加。
可以在冠状动脉 CT 血管造影后检测到依赖于诊断的心理影响。这些影响对诊断背景下的患者健康和医疗保健具有重要意义,本研究的结果可用于指导该领域的进一步研究。