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[性别对心血管疾病患者保护因素与脆弱因素、依从性及生活质量的影响]

[Influence of gender on protective and vulnerability factors, adherence and quality of life in patients with cardiovascular disease].

作者信息

Alemán Juan Francisco, Rueda Beatriz

机构信息

Departamento de Psicología de la Personalidad, Evaluación y Tratamiento Psicológicos, Universidad Nacional de Educación a Distancia, Madrid, España; Centro de Salud de Agaete, Agaete, Gran Canaria, Las Palmas, España.

Departamento de Psicología de la Personalidad, Evaluación y Tratamiento Psicológicos, Universidad Nacional de Educación a Distancia, Madrid, España.

出版信息

Aten Primaria. 2019 Nov;51(9):529-535. doi: 10.1016/j.aprim.2018.07.003. Epub 2018 Oct 19.

Abstract

OBJECTIVES

To examine gender differences on specific protective factors (PF: acceptance and resilience), vulnerability factors (VF: anger, depression, and anxiety; adherence to treatment and quality of life (QoL) in cardiovascular patients, as well as to study separately the relationships of these factors with adherence and QoL in females and males.

DESIGN

Observational and cross-sectional.

SETTING

Two Primary Care Centres in Gran Canaria.

PARTICIPANTS

One hundred and ninety-eight cardiovascular patients (91 males and 107 females) participated.

MAIN MEASUREMENTS

Acceptance was assessed by the ICQ scale; resilience by the CD-RISC; depression by the PHQ-9; anxiety by the HADS; Anger-In and Anger-Out by the STAXI-2; QoL by the SF-36; and adherence by a self-reported scale.

RESULTS

Females exhibited higher anxiety (95% CI: 6.3-7.9) and adherence to reducing smoking (95% CI: 9.4-10.0) and drinking (95% CI: 9.6-10.1), and lower Anger-Out (95% CI: 8.9-10.0), mental QoL (95% CI: 47.0-51.3) and adherence to medication (95% CI: 22.2-23.3) compared to males. Acceptance was associated with better adherence only in women. There were more VF related to worse adherence in males. Anxiety had a negative impact on adherence, and QoL was positively associated with PF, and negatively with VF in both groups.

CONCLUSIONS

Gender differences in QoL, some VF, and adherence are observed, in addition to the beneficial role of Acceptance in women.

摘要

目的

研究心血管疾病患者在特定保护因素(PF:接纳和心理弹性)、易损因素(VF:愤怒、抑郁和焦虑;治疗依从性及生活质量(QoL))方面的性别差异,并分别研究这些因素与女性和男性的依从性及生活质量之间的关系。

设计

观察性横断面研究。

地点

大加那利岛的两个初级保健中心。

参与者

198名心血管疾病患者(91名男性和107名女性)参与研究。

主要测量指标

接纳程度通过ICQ量表评估;心理弹性通过CD - RISC量表评估;抑郁通过PHQ - 9量表评估;焦虑通过HADS量表评估;愤怒内向和愤怒外向通过STAXI - 2量表评估;生活质量通过SF - 36量表评估;依从性通过自我报告量表评估。

结果

与男性相比,女性表现出更高的焦虑水平(95%置信区间:6.3 - 7.9)、更高的减少吸烟依从性(95%置信区间:9.4 - 10.0)和饮酒依从性(95%置信区间:9.6 - 10.1),以及更低的愤怒外向水平(95%置信区间:8.9 - 10.0)、心理生活质量(95%置信区间:47.0 - 51.3)和药物治疗依从性(95%置信区间:22.2 - 23.3)。接纳仅在女性中与更好的依从性相关。男性中与较差依从性相关的易损因素更多。焦虑对依从性有负面影响,生活质量在两组中均与保护因素呈正相关,与易损因素呈负相关。

结论

除了接纳对女性具有有益作用外,还观察到生活质量、一些易损因素和依从性方面的性别差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6951/6945135/e416c240eef2/fx1.jpg

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