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[心理心脏护理在住院康复中的有效性:一项试点研究]

[Effectiveness of Psychocardiological Care in Inpatient Rehabilitation: A Pilot Study].

作者信息

Priegnitz Julia, Langheim Eike, Rademacher Wilma, Schmitz Christoph, Köllner Volker

机构信息

Reha-Zentrum Seehof, Verhaltensmedizin und Psychosomatik, Teltow.

Forschungsgruppe Psychosomatische Rehabilitation Medizinische Klinik mit Schwerpunkt Psychosomatik Centrum für Innere Medizin und Dermatologie Charité - Universitätsmedizin Berlin, Psychosomatik, Berlin.

出版信息

Psychother Psychosom Med Psychol. 2020 May;70(5):190-196. doi: 10.1055/a-1023-4609. Epub 2019 Dec 10.

Abstract

An integrative patient-centered care concept is increasingly demanded for treatment of cardiac patients with concomitant mental disorders. The present study aims to investigate the effect of an integrated concept of psycho-cardiac care (PK) versus a monodisciplinary cardiac (K) or psychosomatic (PSO) care. Patients were examined at baseline (T0), at the time of discharge from the rehabilitation program (T1) and after 6 month (T2). General anxiety, depression (HADS), cardiac anxiety (HAF) and quality of life (SF-12) were evaluated using computer-assisted questionnaires. A total of 93 patients were included (PK: n=37, 55.5 years SD=8.0, 43.2% female; K: n=32, 53.6 years SD=8.2, 34.4% female; PSO: n=24, 55.5 years SD=5.0, 45.8% female). Patients in the PK-group showed a significant reduction of heart-focused anxiety (HAF fear p=0.004) and a significant improvement in quality of life (SF-12 physical p=0.034) during follow-up. In contrast, these parameters remained unchanged in patients in the K- and PSO-groups. The results indicate that cardiac-patients with concomitant mental disorders benefit only from an integrated psycho-cardiac treatment concept. The findings provide first data to psycho-cardiac treatment in stationary rehabilitation and support previous clinical experiences. But further research is required to show the advantage of a psycho-cardiac concept towards monodisciplinary care.

摘要

对于伴有精神障碍的心脏病患者的治疗,越来越需要一种以患者为中心的综合护理理念。本研究旨在调查心理心脏护理(PK)综合概念与单一学科心脏护理(K)或心身护理(PSO)相比的效果。在基线时(T0)、康复项目出院时(T1)和6个月后(T2)对患者进行检查。使用计算机辅助问卷评估一般焦虑、抑郁(HADS)、心脏焦虑(HAF)和生活质量(SF-12)。总共纳入了93名患者(PK组:n = 37,55.5岁,标准差 = 8.0,女性占43.2%;K组:n = 32,53.6岁,标准差 = 8.2,女性占34.4%;PSO组:n = 24,55.5岁,标准差 = 5.0,女性占45.8%)。PK组患者在随访期间心脏聚焦焦虑(HAF恐惧p = 0.004)显著降低,生活质量(SF-12身体p = 0.034)显著改善。相比之下,K组和PSO组患者的这些参数保持不变。结果表明,伴有精神障碍的心脏病患者仅从心理心脏综合治疗概念中受益。这些发现为住院康复中的心理心脏治疗提供了首批数据,并支持了先前的临床经验。但需要进一步研究以证明心理心脏概念相对于单一学科护理的优势。

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