Sin Nancy L, Moskowitz Judith Tedlie, Whooley Mary A
From the Center for Healthy Aging and Department of Biobehavioral Health (Sin), The Pennsylvania State University, University Park, Pennsylvania; Department of Medical Social Sciences (Moskowitz), Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Departments of Medicine and Epidemiology & Biostatistics (Whooley), University of California, San Francisco, California; and Veterans Affairs Medical Center (Whooley), San Francisco, California.
Psychosom Med. 2015 Nov-Dec;77(9):1058-66. doi: 10.1097/PSY.0000000000000238.
Positive psychological states are linked to superior health and longevity, possibly due to behavioral factors. We evaluated cross-sectional and 5-year associations between positive affect and health behaviors in patients with coronary heart disease (CHD).
Outpatients with CHD reported positive affect, physical activity, sleep quality, medication adherence, cigarette smoking, and alcohol use at baseline (n = 1022) and 5 years later (n = 662). Covariates in regression analyses included demographics, cardiac disease severity, and depressive symptoms.
At baseline, higher positive affect (per 1 standard deviation) was associated with better health behaviors: physical activity (odds ratio [OR] = 1.52, 95% 95% confidence interval [CI] = 1.30-1.77, p < .001), sleep quality (OR = 1.24, 95% CI = 1.04-1.48, p = .015), medication adherence (OR = 1.46, 95% CI = 1.12-1.90, p = .005), and nonsmoking (OR = 1.29, 95% CI = 1.06-1.57, p = .012), but was unrelated to alcohol use. Baseline positive affect did not predict health behaviors at follow-up, accounting for baseline behaviors. However, increases in positive affect across 5 years co-occurred with improvements in physical activity (B = 0.023, standard error [SE] = 0.008, p = .002), sleep quality (B = 0.011, SE = 0.005, p = .039), and medication adherence (B = 0.014, SE = 0.004, p < .001), but not smoking status (OR = 1.07, 95% CI = 0.73-1.55, p = .74).
Positive affect was associated with health behaviors among patients with CHD. Efforts to sustain or enhance positive affect may be promising for promoting better health behaviors.
积极的心理状态与更优的健康状况和更长的寿命相关，这可能归因于行为因素。我们评估了冠心病（CHD）患者中积极情绪与健康行为之间的横断面关联及5年关联。
冠心病门诊患者在基线时（n = 1022）及5年后（n = 662）报告了积极情绪、身体活动、睡眠质量、药物依从性、吸烟情况和饮酒情况。回归分析中的协变量包括人口统计学特征、心脏病严重程度和抑郁症状。
在基线时，更高的积极情绪（每增加1个标准差）与更好的健康行为相关：身体活动（优势比[OR] = 1.52，95%置信区间[CI] = 1.30 - 1.77，p < .001）、睡眠质量（OR = 1.24，95% CI = 1.04 - 1.48，p = .015）、药物依从性（OR = 1.46，95% CI = 1.12 - 1.90，p = .005）和不吸烟（OR = 1.29，95% CI = 1.06 - 1.57，p = .012），但与饮酒无关。基线时的积极情绪并不能预测随访时的健康行为，即便考虑了基线行为。然而，5年期间积极情绪的增加与身体活动的改善（B = 0.023，标准误[SE] = 0.008，p = .002）、睡眠质量的改善（B = 0.011，SE = 0.005，p = .039）和药物依从性的改善（B = 0.014，SE = 0.004，p < .001）同时出现，但与吸烟状况无关（OR = 1.07，95% CI = 0.73 - 1.55，p = .74）。
积极情绪与冠心病患者的健康行为相关。维持或增强积极情绪的努力可能有助于促进更好的健康行为。
