Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Department of Cardiology in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Health Qual Life Outcomes. 2020 Mar 12;18(1):68. doi: 10.1186/s12955-020-01297-0.
Recurrent chest pain episodes with no clear explanation may affect patients' psychological wellbeing and health-related quality of life (HRQoL) negatively. Despite the fact that a significant amount of patients with non-cardiac chest pain (NCCP) might have a history of Cardiac Disease (CD), there is today a lack of knowledge on how CD influences the association between psychological wellbeing and HRQoL in patients with NCCP. Therefore, the aim of this study is to describe HRQoL in patients with NCCP, with or without history of CD, and to explore the association between HRQoL and cardiac anxiety, depressive symptoms, fear of body sensations and somatization.
Five hundred fifty-two patients discharged with NCCP from four hospitals in Southeast Sweden completed the EQ-5D, Cardiac Anxiety Questionnaire, Patient Health Questionnaire-9, Body Sensations Questionnaire, and Patient Health Questionnaire-15.
Fifty precent reported at least moderate problems regarding pain/discomfort and 25% reported at least moderate problems in the HRQoL dimensions mobility, usual activities, and anxiety/depression. Patients with NCCP and history of CD reported significantly lower HRQoL (p ≤ 0.05) compared to patients with NCCP without CD. In the total study population, cardiac anxiety, depressive symptoms, and somatization had weak significant negative associations (beta = 0.187-0.284, p < 0.001) with HRQoL. In patients with history of CD, the association between depressive symptoms and HRQoL was moderate (beta = - 0.339, p < 0.001), compared to weak association in patients without CD (beta = - 0.193, p < 0.001). On the other hand, the association between cardiac anxiety and HRQoL was weak in both patients with history of CD (beta = - 0.156, p = 0.05), and in those without (beta = - 0.229, p < 0.001).
Patients with NCCP, in particular those with history of CD, reported low levels of HRQoL, which was associated with psychological distress. This should be considered when developing psychological interventions aiming to improve HRQoL in patients with NCCP.
反复发作且无明确原因的胸痛可能会对患者的心理健康和健康相关生活质量（HRQoL）产生负面影响。尽管有相当数量的非心源性胸痛（NCCP）患者可能有心脏病（CD）病史，但目前对于 CD 如何影响 NCCP 患者的心理健康和 HRQoL 之间的关联知之甚少。因此，本研究旨在描述有或无 CD 病史的 NCCP 患者的 HRQoL，并探讨 HRQoL 与心脏焦虑、抑郁症状、身体感觉恐惧和躯体化之间的关系。
从瑞典东南部的四家医院出院的 552 名 NCCP 患者完成了 EQ-5D、心脏焦虑问卷、患者健康问卷-9、身体感觉问卷和患者健康问卷-15。
50%的患者报告至少有中度疼痛/不适问题，25%的患者报告至少有中度活动、焦虑/抑郁问题。有 CD 病史的 NCCP 患者报告的 HRQoL 明显低于没有 CD 病史的患者（p≤0.05）。在整个研究人群中，心脏焦虑、抑郁症状和躯体化与 HRQoL 呈弱显著负相关（β=0.187-0.284，p<0.001）。在有 CD 病史的患者中，抑郁症状与 HRQoL 的相关性为中度（β=-0.339，p<0.001），而在没有 CD 病史的患者中为弱相关（β=-0.193，p<0.001）。另一方面，在有 CD 病史的患者中，心脏焦虑与 HRQoL 的相关性较弱（β=-0.156，p=0.05），在没有 CD 病史的患者中则较弱（β=-0.229，p<0.001）。
NCCP 患者，特别是有 CD 病史的患者，报告的 HRQoL 水平较低，这与心理困扰有关。在为 NCCP 患者制定旨在提高 HRQoL 的心理干预措施时，应考虑这一点。
