Fuchs-Strizek Rita, Berger Thomas
Sonderkrankenanstalt Rehabilitationszentrum Saalfelden, Thorerstraße 26, 5760, Saalfelden, Österreich.
Wien Med Wochenschr. 2018 Feb;168(1-2):31-38. doi: 10.1007/s10354-017-0606-y. Epub 2017 Oct 26.
Psychosocial risk factors contribute to the development and progression of cardiovascular diseases. They are associated with an unhealthy lifestyle, low patient adherence, alterations in autonomic function and endocrine markers. Thus, in cardiac rehabilitation, psychosocial risk factors should be assessed besides somatic factors. Patients with clinically significant symptoms ought to be referred for further psychological diagnostics. Depending on the findings, patients should be offered psychological interventions like relaxation training, stress management courses, smoking cessation programmes and individual counselling. Individual counselling includes psychoeducation, focused interventions and building motivation for further treatment. With regard to evidence-based interventions, motivating communication as well as behaviour and coping planning deserves particular notice. In terms of clinical efficacy, psychological interventions are evaluated and partially effective on cardiac prognosis. Hence, the significance of psychocardiology in inpatient rehabilitation should be enhanced.
心理社会风险因素会促进心血管疾病的发生和发展。它们与不健康的生活方式、患者依从性低、自主神经功能改变以及内分泌指标有关。因此,在心脏康复中,除了躯体因素外,还应评估心理社会风险因素。有临床显著症状的患者应转诊进行进一步的心理诊断。根据诊断结果,应为患者提供心理干预措施,如放松训练、压力管理课程、戒烟计划和个体咨询。个体咨询包括心理教育、针对性干预以及激发进一步治疗的动机。关于循证干预措施,激励性沟通以及行为和应对计划值得特别关注。就临床疗效而言,心理干预措施对心脏预后有一定评估效果且部分有效。因此,应加强心身医学在住院康复中的重要性。