Department of Psychiatry, Harvard Medical School, Boston, MA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA.
Department of Psychiatry, Harvard Medical School, Boston, MA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA.
Psychosomatics. 2018 Jan-Feb;59(1):1-18. doi: 10.1016/j.psym.2017.09.003. Epub 2017 Sep 18.
Psychiatric disorders, such as depression, are very common in cardiac patients and are independently linked to adverse cardiac outcomes, including mortality. Collaborative care and other integrated care models have been used successfully to manage psychiatric conditions in patients with heart disease, with beneficial effects on function and other outcomes. Novel programs using remote delivery of mental health interventions and promotion of psychological well-being may play an increasingly large role in supporting cardiovascular health.
We review prior studies of standard and expanded integrated care programs among patients with cardiac disease, examine contemporary intervention delivery methods (e.g., Internet or mobile phone) that could be adapted for these programs, and outline mental health-related interventions to promote healthy behaviors and overall recovery across all cardiac patients.
Standard integrated care models for mental health disorders are effective at improving mood, anxiety, and function in patients with heart disease. Novel, "blended" collaborative care models may have even greater promise in improving cardiac outcomes, and interfacing with cardiac patients via mobile applications, text messages, and video visits may provide additional benefit. A variety of newer interventions using stress management, mindfulness, or positive psychology have shown promising effects on mental health, health behaviors, and overall cardiac outcomes.
Further study of novel applications of collaborative care and related interventions is warranted given the potential of these programs to increase the reach and effect of mental health interventions in patients with heart disease.
在心脏病患者中，精神障碍（如抑郁症）非常常见，且与不良心脏结局（包括死亡率）独立相关。协作式护理和其他综合护理模式已成功用于管理心脏病患者的精神疾病，对功能和其他结局有有益影响。使用心理健康干预措施的远程传输和促进心理幸福感的新方案可能在支持心血管健康方面发挥越来越大的作用。
我们回顾了心脏病患者的标准和扩展综合护理计划的先前研究，研究了可用于这些计划的当代干预传递方法（例如互联网或移动电话），并概述了促进所有心脏病患者健康行为和整体康复的心理健康相关干预措施。
针对心理健康障碍的标准综合护理模式可有效改善心脏病患者的情绪、焦虑和功能。新型“混合”协作式护理模式在改善心脏结局方面可能具有更大的前景，通过移动应用程序、短信和视频访问与心脏病患者进行交互可能会带来额外的益处。使用压力管理、正念或积极心理学的多种新型干预措施已显示出对心理健康、健康行为和整体心脏结局的有希望的影响。
鉴于这些计划有可能增加心脏病患者心理健康干预的覆盖面和效果，因此有必要进一步研究协作式护理和相关干预措施的新应用。
