Crawshaw Jacob, Rimington Helen, Weinman John, Chilcot Joseph
Health Psychology Section, Psychology Department, Institute of Psychiatry, King's College London, 5th Floor Bermondsey Wing, Guy's Campus, London Bridge, London, SE19RT, UK.
Ann Behav Med. 2015 Oct;49(5):769-75. doi: 10.1007/s12160-015-9695-2.
The aim of the present study was to examine whether profiles of illness perceptions are associated with 10-year survival following cardiac valve replacement surgery.
Illness perceptions were evaluated in 204 cardiac patients awaiting first-time valve replacement and again 1 year post-operatively using cluster analysis. All-cause mortality was recorded over a 10-year period. At 1 year, 136 patients were grouped into one of four profiles (stable positive, stable negative, changed from positive to negative, changed from negative to positive).
The median follow-up was 3063 days (78 deaths). After controlling for clinical covariates, including markers of function, patients who changed illness perceptions from positive to negative beliefs 1 year post-surgery had an increased mortality risk (hazard ratio (HR) = 3.2, 95% confidence interval (CI) 1.2-8.3, p = .02) compared to patients who held positive stable perceptions.
Following cardiac valve replacement, developing negative illness perceptions over the first post-operative year predicts long-term mortality. Early screening and intervention to alter this pattern of beliefs may be beneficial.
本研究旨在探讨疾病认知概况是否与心脏瓣膜置换术后10年生存率相关。
采用聚类分析对204例等待首次瓣膜置换的心脏病患者术前及术后1年的疾病认知情况进行评估。记录10年期间的全因死亡率。术后1年时，136例患者被分为四种类型之一（稳定积极型、稳定消极型、由积极转为消极型、由消极转为积极型）。
中位随访时间为3063天（78例死亡）。在控制了包括功能指标在内的临床协变量后，与术后1年维持稳定积极疾病认知的患者相比，术后1年疾病认知从积极转为消极的患者死亡风险增加（风险比（HR）= 3.2，95%置信区间（CI）1.2 - 8.3，p = 0.02）。
心脏瓣膜置换术后，术后第一年出现消极的疾病认知预示着长期死亡率。早期筛查和干预以改变这种认知模式可能有益。
