a Department of Psychology , University of Sheffield , Sheffield , UK.
Psychol Health. 2014;29(11):1265-82. doi: 10.1080/08870446.2014.923885. Epub 2014 Jun 18.
Many patients who attend an emergency department (ED) with chest pain receive a diagnosis of non-cardiac chest pain (NCCP), and often suffer poor psychological outcomes and continued pain. This study assessed the role of illness representations in explaining psychological distress and continued chest pain in patients attending an ED.
ED NCCP patients (N = 138) completed measures assessing illness representations, anxiety, depression and quality of life (QoL) at baseline, and chest pain at one month.
Illness representations explained significant amounts of the variance in anxiety (Adj. R² = .38), depression (Adj. R² = .18) and mental QoL (Adj. R² = .36). A belief in psychological causes had the strongest associations with outcomes. At one month, 28.7% of participants reported experiencing frequent pain, 13.2% infrequent pain and 58.1% no pain. Anxiety, depression and poor QoL, but not illness representations, were associated with continued chest pain.
The findings suggest that (i) continued chest pain is related to psychological distress and poor QoL, (ii) interventions should be aimed at reducing psychological distress and improving QoL and (iii) given the associations between perceived psychological causes and psychological distress/QoL, NCCP patients in the ED might benefit from psychological therapies to manage their chest pain.
许多因胸痛到急诊科就诊的患者被诊断为非心源性胸痛（NCCP），他们往往会出现较差的心理结局和持续的疼痛。本研究评估了疾病认知在解释急诊科 NCCP 患者的心理困扰和持续胸痛中的作用。
ED NCCP 患者（N=138）在基线时完成了评估疾病认知、焦虑、抑郁和生活质量（QoL）的量表，一个月时评估了胸痛。
疾病认知解释了焦虑（调整后的 R²=.38）、抑郁（调整后的 R²=.18）和心理 QoL（调整后的 R²=.36）的大量方差。对心理原因的信念与结果的关联最强。一个月时，28.7%的参与者报告频繁出现疼痛，13.2%报告偶尔疼痛，58.1%报告无疼痛。焦虑、抑郁和较差的 QoL，但不是疾病认知，与持续胸痛相关。
研究结果表明：（i）持续胸痛与心理困扰和较差的 QoL 相关；（ii）干预措施应旨在减轻心理困扰和改善 QoL；（iii）鉴于感知到的心理原因与心理困扰/QoL 之间的关联，急诊科的 NCCP 患者可能受益于心理治疗来管理他们的胸痛。
