Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.
Escuela Andaluza de Salud Pública, Granada, Spain.
PLoS One. 2020 Jan 31;15(1):e0228262. doi: 10.1371/journal.pone.0228262. eCollection 2020.
Patients diagnosed with coronary heart disease should follow lifestyle recommendations that can reduce their cardiovascular risk (e.g., avoid smoking). However, some patients fail to follow these recommendations and engage in unhealthy behavior. With the aim to identify psychosocial factors that characterize patients at high risk of repeated cardiovascular events, we investigated the relationship between social support, mental health (coping, self-esteem, and perceived stress), and unhealthy behavior. We conducted a cross-sectional study of 419 patients recently diagnosed with coronary heart disease (myocardial infarction or angina) who participated in the National Health Survey in Spain (2018). Unhealthy behaviors were defined according to the European Guidelines on cardiovascular disease prevention. Only 1% of patients reported no unhealthy behaviors, with 11% reporting one, 40% two, 35% three, and 13% four or more unhealthy behaviors. In multiple regression controlling for demographic and traditional risk factors, mental health was the only significant psychosocial factor, doubling the odds of accumulated unhealthy behaviors, OR(high vs. low) = 2.03, 95% CI [1.14, 3.64]. Mental health was especially strongly related to unhealthy behavior among patients with obesity, OR(high vs. low) = 3.50, 95% CI [1.49, 8.45]. The relationship between mental health and unhealthy behaviors suggests that a large proportion of patients may not adhere to lifestyle recommendations not because they purposefully choose to do so, but because they lack coping skills to maintain the recommended healthy behaviors. Low mental well-being may be especially detrimental for behavior change of patients with obesity.
被诊断患有冠心病的患者应遵循可降低心血管风险的生活方式建议（例如，避免吸烟）。然而，一些患者未能遵循这些建议，采取了不健康的行为。为了确定哪些心理社会因素可使患者再次发生心血管事件的风险增高，我们研究了社会支持、心理健康（应对方式、自尊和感知压力）与不健康行为之间的关系。我们对最近被诊断为冠心病（心肌梗死或心绞痛）的 419 名患者进行了横断面研究，这些患者参与了西班牙的国家健康调查（2018 年）。不健康行为根据欧洲心血管疾病预防指南定义。只有 1%的患者报告没有不健康行为，11%的患者报告有一种不健康行为，40%的患者报告两种，35%的患者报告三种，13%的患者报告四种或更多不健康行为。在控制人口统计学和传统危险因素的多元回归分析中，心理健康是唯一显著的心理社会因素，使累积不健康行为的几率增加一倍，OR（高 vs. 低）=2.03，95%CI[1.14,3.64]。心理健康与不健康行为之间的关系表明，很大一部分患者可能不遵守生活方式建议，不是因为他们有意选择这样做，而是因为他们缺乏应对技巧来维持推荐的健康行为。心理健康水平低可能对肥胖患者的行为改变特别不利。
