Brink Eva
Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.
Open Nurs J. 2012;6:90-4. doi: 10.2174/1874434601206010090. Epub 2012 Aug 30.
The present study addresses factors that contributed to explaining the variance in health-related quality of life (HRQOL) one year after myocardial infarction, considering both illness-related and health-promoting factors. The aim was to elucidate the influence of depression, fatigue, optimism and sense of coherence on HRQOL. The sample consisted of 95 persons who had been treated for myocardial infarction. Correlation and multiple regression analyses were performed. The results showed that depression, fatigue, optimism and sense of coherence variables were all correlated with both the physical and the mental dimensions of HRQOL. In two multiple regression analyses where the physical component score (PCS) and the mental component score (MCS) were the criterion variables, fatigue contributed to the explained variance in the PCS (p< 0.001), and both depression (p< 0.01) and fatigue (p< 0.01) contributed to explained the variance in the MCS, after controlling for age and gender. To conclude, fatigue was the most significant variable associated with HRQOL, which was interpreted as having the following clinical implication: When a person suffers from post-myocardial infarction fatigue, this must be addressed first. Clearly, it is time to take the problems of patients who suffer from post-myocardial infarction fatigue seriously. It is of vital importance to develop and evaluate fatigue relief strategies in cardiovascular nursing and to test them in interventional studies. This does not exclude investing in health-promoting factors, e.g. sense of coherence, in coronary care interventions. Intervention strategies focusing on both illness-related and salutogentic factors may be optimal. This is a question for further research.
本研究探讨了心肌梗死后一年健康相关生活质量（HRQOL）差异的影响因素，同时考虑了疾病相关因素和健康促进因素。目的是阐明抑郁、疲劳、乐观和连贯感对HRQOL的影响。样本包括95名接受过心肌梗死治疗的患者。进行了相关性和多元回归分析。结果表明，抑郁、疲劳、乐观和连贯感变量均与HRQOL的身体和心理维度相关。在两项以身体成分得分（PCS）和心理成分得分（MCS）为标准变量的多元回归分析中，在控制年龄和性别后，疲劳对PCS的解释方差有贡献（p<0.001），抑郁（p<0.01）和疲劳（p<0.01）均对MCS的解释方差有贡献。总之，疲劳是与HRQOL相关的最显著变量，这具有以下临床意义：当一个人患有心肌梗死后疲劳时，必须首先解决这个问题。显然，是时候认真对待心肌梗死后疲劳患者的问题了。在心血管护理中制定和评估缓解疲劳的策略并在干预研究中进行测试至关重要。这并不排除在冠心病护理干预中投资于健康促进因素，例如连贯感。关注疾病相关因素和健康促进因素的干预策略可能是最佳的。这是一个有待进一步研究的问题。
