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躯体和心理共病对急性心肌梗死患者生活质量的影响:来自土耳其的一项多中心、横断面观察性研究。

The impact of physical and psychological comorbid conditions on the quality of life of patients with acute myocardial infarction: a multi-center, cross-sectional observational study from Turkey.

机构信息

Department of Psychiatry, School of Medicine, Ege University, Izmir, Turkey.

出版信息

Int J Psychiatry Med. 2013;45(2):97-109. doi: 10.2190/PM.45.2.a.

Abstract

OBJECTIVE

Acute myocardial infarction (MI) has significant and detrimental effects on the lifestyles of the patients. It has been shown that quality of life (QoL) in patients with MI is impaired in every aspect. This study aims to evaluate the impact of depression and physical comorbidity on QoL in Turkish patients with acute first MI.

METHOD

This multi-center cross-sectional study was carried out in 15 centers with 998 patients hospitalized for acute first MI. For detection of depression, Beck Depression Inventory (BDI) was used. For evaluation of QoL, World Health Organization Quality of Life Questionnaire (WHOQOL) was applied.

RESULTS

The mean age of the patients was 57.5 +/- 10.1 years and 79.2 % (n = 792) of the patients were men. Patients with comorbid depression (BDI > or = 10) and comorbid medical conditions, and female patients had significantly lower scores in every domain of WHOQOL. In the regression analysis model, female gender, low education, comorbid medical conditions, especially comorbid hypertension, and BDI score were found to have a significant effect on the domains of WHOQOL.

CONCLUSIONS

Female patients are more prone to impairment in quality of life after myocardial infarction. Both comorbid medical conditions and depression have a significant impact on the impairment of QoL in Turkish patients with acute MI. In order to improve the subjective wellbeing of post MI patients, both psychiatric and physical comorbidities must be detected and managed even in the short-term.

摘要

目的

急性心肌梗死(MI)对患者的生活方式有重大且不利的影响。已经表明,MI 患者的生活质量(QoL)在各个方面都受到损害。本研究旨在评估土耳其急性首发 MI 患者的抑郁和合并躯体疾病对 QoL 的影响。

方法

这是一项多中心横断面研究,在 15 个中心进行,共纳入 998 例因急性首发 MI 住院的患者。采用贝克抑郁量表(BDI)检测抑郁,应用世界卫生组织生活质量量表(WHOQOL)评估 QoL。

结果

患者的平均年龄为 57.5±10.1 岁,79.2%(n=792)为男性。合并抑郁(BDI≥10)和合并躯体疾病的患者,以及女性患者在 WHOQOL 的各个领域得分明显较低。在回归分析模型中,女性、低教育程度、合并躯体疾病,尤其是合并高血压,以及 BDI 评分被发现对 WHOQOL 的各个领域有显著影响。

结论

女性患者在心肌梗死后更易出现生活质量受损。合并躯体疾病和抑郁对土耳其急性 MI 患者 QoL 的损害有显著影响。为了提高 MI 后患者的主观幸福感,必须在短期内发现和管理躯体合并症和精神合并症。

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