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预先存在的早发性冠心病患者的疾病感知与健康相关生活质量之间的关系。

Association between illness perception and health-related quality of life in patients with preexisting premature coronary artery disease.

机构信息

Research Department, Tehran Heart Centre, Tehran University of Medical Sciences, Tehran, Iran.

Psychiatry Department, Tehran University of Medical Sciences, Tehran, Iran; Tehran Heart Center, North Kargarstreet, Teharn 1411713138, Iran.

出版信息

J Psychosom Res. 2019 May;120:118-123. doi: 10.1016/j.jpsychores.2019.03.001. Epub 2019 Mar 2.

Abstract

OBJECTIVES

Illness perception in younger age differs from that in older age. We aimed to examine the association between illness perception and health-related quality of life (HRQoL) in patients with premature coronary artery disease (CAD).

METHODS

In a cross-sectional design, between November 2016 and September 2017, a total of 779 adults (52.5% female) with premature CAD (diagnosed in men aged ≤ 45 y and women aged ≤ 55 y) completed the Beck Depression Inventory-II, the Beck Anxiety Inventory, the Brief Illness Perception, and the Short-Form Health Survey 36 questionnaires in an outpatient clinic 8 years after the diagnosis.

RESULTS

The patients were treated with coronary artery bypass graft surgery (24.6%), percutaneous coronary intervention (39.5%), and medical treatment (35.8%). The cognitive, emotional, and comprehension aspects of illness perception had significant associations with both physical and mental health in univariable analysis (all Ps < 0.001). After adjustments for potential confounding factors, higher cognitive perception was independently associated with greater physical health [OR = 4.13, Confidence interval (CI): 3.53-4.72] and mental health (OR = 3.17, CI: 2.57-3.77). Additionally, emotional perception was also directly associated with higher physical (OR = 1.62, CI: 1.17-2.06) and mental (OR = 1.52, CI: 1.07-1.96) health; all Ps < 0.001.

CONCLUSIONS

Of the 3 different aspects of illness perception, cognitive perception appeared to have the greatest influence on HRQoL, either physical or mental health. Further studies are needed to investigate whether cognitive interventions can improve HRQoL in premature CAD patients and, thus, their outcome.

摘要

目的

年轻人的疾病感知与老年人不同。本研究旨在探讨早发冠心病患者疾病感知与健康相关生活质量(HRQoL)之间的关系。

方法

采用横断面设计,于 2016 年 11 月至 2017 年 9 月,在门诊共纳入 779 名早发冠心病(男性诊断为≤45 岁,女性诊断为≤55 岁)成年患者,他们在确诊 8 年后完成贝克抑郁量表 II 版、贝克焦虑量表、简短疾病感知问卷和健康调查简表 36 问卷。

结果

患者接受冠状动脉旁路移植术(24.6%)、经皮冠状动脉介入治疗(39.5%)和药物治疗(35.8%)。在单变量分析中,疾病感知的认知、情绪和理解方面与生理和心理健康均具有显著相关性(所有 P 值均<0.001)。在调整潜在混杂因素后,较高的认知感知与更好的生理健康(OR=4.13,置信区间[CI]:3.53-4.72)和心理健康(OR=3.17,CI:2.57-3.77)独立相关。此外,情绪感知也与较高的生理健康(OR=1.62,CI:1.17-2.06)和心理健康(OR=1.52,CI:1.07-1.96)直接相关;所有 P 值均<0.001。

结论

在疾病感知的 3 个不同方面中,认知感知似乎对 HRQoL(生理或心理健康)的影响最大。需要进一步研究认知干预是否可以改善早发冠心病患者的 HRQoL,并改善其结局。

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