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精神安宁可预测充血性心力衰竭患者的5年死亡率。

Spiritual peace predicts 5-year mortality in congestive heart failure patients.

作者信息

Park Crystal L, Aldwin Carolyn M, Choun Soyoung, George Login, Suresh Damodhar P, Bliss Deborah

机构信息

Department of Psychology, University of Connecticut.

Program in Human Development & Family Sciences, School of Social & Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University.

出版信息

Health Psychol. 2016 Mar;35(3):203-10. doi: 10.1037/hea0000271. Epub 2015 Sep 28.

Abstract

OBJECTIVE

Spirituality is favorably related to depression, quality of life, hospitalizations, and other important outcomes in congestive heart failure (CHF) patients but has not been examined as a predictor of mortality risk in this population. Given the well-known difficulties in managing CHF, we hypothesized that spirituality would be associated with lower mortality risk, controlling for baseline demographics, functional status, health behaviors, and religiousness.

METHOD

Participants were 191 CHF patients (64% male; M age = 68.6 years, SD = 10.1) who completed a baseline survey and were then followed for 5 years.

RESULTS

Nearly 1/3 of the sample (32%) died during the study period. Controlling for demographics and health status, smoking more than doubled the risk of mortality, whereas alcohol consumption was associated with slightly lower risk of mortality. Importantly, adherence to healthy lifestyle recommendations was associated with halved mortality risk. Although both religion and spirituality were associated with better health behaviors at baseline in bivariate analyses, a proportional hazard model showed that only spirituality was significantly associated with reduced mortality risk (by 20%), controlling for demographics, health status, and health behaviors.

CONCLUSIONS

Experiencing spiritual peace, along with adherence to a healthy lifestyle, were better predictors of mortality risk in this sample of CHF patients than were physical health indicators such as functional status and comorbidity. Future research might profitably examine the efficacy of attending to spiritual issues along with standard lifestyle interventions.

摘要

目的

精神层面与充血性心力衰竭(CHF)患者的抑郁、生活质量、住院情况及其他重要预后指标呈正相关,但尚未被视为该人群死亡风险的预测因素。鉴于CHF管理中存在的诸多难题,我们假设,在控制基线人口统计学特征、功能状态、健康行为和宗教信仰的情况下,精神层面与较低的死亡风险相关。

方法

研究对象为191名CHF患者(64%为男性;平均年龄=68.6岁,标准差=10.1),他们完成了基线调查,随后被随访5年。

结果

近三分之一的样本(32%)在研究期间死亡。在控制人口统计学特征和健康状况后,吸烟使死亡风险增加了一倍多,而饮酒与略低的死亡风险相关。重要的是,坚持健康的生活方式建议与死亡风险减半相关。虽然在双变量分析中,宗教信仰和精神层面在基线时都与更好的健康行为相关,但比例风险模型显示,在控制人口统计学特征、健康状况和健康行为后,只有精神层面与降低的死亡风险显著相关(降低20%)。

结论

在这个CHF患者样本中,体验精神安宁以及坚持健康的生活方式,比功能状态和合并症等身体健康指标更能预测死亡风险。未来的研究可能会从同时关注精神问题和标准生活方式干预的效果中受益。

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