以心脏为中心的焦虑与非心源性胸痛患者的医疗寻求行为：一项前瞻性研究。

Heart-focused anxiety and health care seeking in patients with non-cardiac chest pain: A prospective study.

机构信息

School of Psychology, Faculty of Social Sciences, University Laval, 2325 rue des Bibliothèques, Pavillon Félix-Antoine-Savard, room 1018, Québec G1V 0A6, Québec, Canada; Research Center of the university affiliated hospital Hôtel-Dieu de Lévis, Chaudière-Appalaches Integrated Center for Health and Social Services, 143 rue Wolfe, Pavillon des Augustines, room 4817, Lévis G6V 3Z1, Québec, Canada.

Research Center of the university affiliated hospital Hôtel-Dieu de Lévis, Chaudière-Appalaches Integrated Center for Health and Social Services, 143 rue Wolfe, Pavillon des Augustines, room 4817, Lévis G6V 3Z1, Québec, Canada.

出版信息

Gen Hosp Psychiatry. 2018 Jan-Feb;50:83-89. doi: 10.1016/j.genhosppsych.2017.10.007. Epub 2017 Oct 26.

DOI:10.1016/j.genhosppsych.2017.10.007

PMID:29120733

Abstract

OBJECTIVES

This study aimed to estimate the incidence of medical consultations six months after an emergency department (ED) consultation for non-cardiac chest pain (NCCP). It also investigated the role of heart-focused anxiety (HFA) and other factors in predicting an increased healthcare utilization in these patients.

METHOD

This was a prospective study of 428 patients who came to an ED with NCCP. Patients completed an interview and questionnaires assessing HFA, psychological distress, the characteristics of NCCP, and comorbidities. Their medical consultations were assessed by telephone interview six months later. The contribution of each factor was assessed using a binomial negative regression.

RESULTS

Eighty-three percent of patients reported at least one medical consultation (mean=3.1, standard deviation=3.9). HFA (incident rate ratio 1.01; 95% CI, 1.00-1.02), the presence of a medical condition (2.14; 1.51-3.03), NCCP frequency (1.49; 1.16-1.91) and NCCP-related interference (1.08; 1.04-1.13) were predictive of further medical consultations.

CONCLUSIONS

A significant proportion of patients with NCCP are at risk of multiple medical consultations following discharge from the ED. HFA appears as a determinant of medical consultations after controlling for multiple confounding factors.

摘要

目的

本研究旨在估计急诊科（ED）非心源性胸痛（NCCP）就诊后 6 个月内医疗咨询的发生率。还调查了心脏聚焦焦虑（HFA）和其他因素在预测这些患者增加医疗保健利用方面的作用。

方法

这是一项对 428 名因 NCCP 就诊 ED 的患者进行的前瞻性研究。患者完成了访谈和问卷调查，评估 HFA、心理困扰、NCCP 的特征和合并症。六个月后通过电话访谈评估他们的医疗咨询情况。使用二项负回归评估每个因素的贡献。

结果

83%的患者报告至少有一次医疗咨询（平均=3.1，标准差=3.9）。HFA（发病率比 1.01；95%CI，1.00-1.02）、存在医疗状况（2.14；1.51-3.03）、NCCP 频率（1.49；1.16-1.91）和 NCCP 相关干扰（1.08；1.04-1.13）与进一步的医疗咨询相关。