Institut du Savoir Montfort, 745a chemin Montréal, Ottawa, Ontario, K1K 0T2, Canada.
Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, Ontario, K1H 8M5, Canada.
Psychiatr Q. 2021 Mar;92(1):273-287. doi: 10.1007/s11126-020-09791-w.
The relationship between body and mind is increasingly recognized in the occurrence and prognosis of cardiac disease. Based on reports detailing the potential (and the influence of certain risk factors) of developing depression and anxiety following cardiovascular disease, or a cardiac event, most notably acute coronary syndrome (ACS), we investigated whether such symptoms also existed in patient cases found at the cardiac rehabilitation unit of an academic hospital of Eastern Ontario. We examined data from charts during a 6-year period (2012-2017). The Hospital Anxiety and Depression Scale cumulated data within a retrospective cross-sectional study, was used to estimate the prevalence of anxious and depressive symptoms that might reflect the presence of psychological distress. Overall, our sample included 1178 patient files, 81.3% of which were diagnosed with ACS and 69.6% were male. 63.1% of the patients were between 60 and 79 years old at the time of diagnosis. Most patients were Caucasian (81.1%), married (60.3%), and living with their family (74.3%), and 49.7% were recorded as overweight or obese. We found that 29.3% of patients reported symptoms of psychological distress. Regression analyses revealed strong negative correlations between the proportion of symptoms of psychological distress and factors like age and functional capacity as measured by metabolic equivalents. Significant associations were also established between symptoms of psychological distress and factors such as obesity, sedentary lifestyle, smoking, and sex (female). This study was undertaken as part of a business case to implement a new cardiac rehabilitation programme in an academic hospital of Eastern Ontario and illustrate to the managers and decision-makers, the important factors to consider and to target when developing a stepped-care program for patients in cardiac rehabilitation in order to prevent psychological distress and how such a program was relevant to their institution.
身心关系在心脏病的发生和预后中越来越受到重视。基于详细报告，心血管疾病或心脏事件（尤其是急性冠状动脉综合征 [ACS]）后会出现抑郁和焦虑的潜在风险（以及某些风险因素的影响），我们调查了在安大略省东部一所学术医院的心脏康复病房中患者是否也存在这些症状。我们检查了 6 年期间（2012-2017 年）的图表数据。使用医院焦虑和抑郁量表（HADS）来回顾性地分析横断面研究中的累积数据，以评估焦虑和抑郁症状的患病率，这些症状可能反映出存在心理困扰。总体而言，我们的样本包括 1178 份患者病历，其中 81.3%被诊断为 ACS，69.6%为男性。诊断时患者年龄在 60-79 岁之间的占 63.1%。大多数患者为白种人（81.1%）、已婚（60.3%）、与家人同住（74.3%），49.7%的患者超重或肥胖。我们发现，29.3%的患者报告有心理困扰症状。回归分析显示，心理困扰症状的比例与年龄和代谢当量测量的功能能力等因素呈强烈负相关。心理困扰症状与肥胖、久坐不动的生活方式、吸烟和性别（女性）等因素之间也存在显著关联。这项研究是作为安大略省东部一所学术医院实施新的心脏康复计划的商业案例的一部分进行的，旨在向管理人员和决策者说明在为心脏康复患者制定分级护理计划时需要考虑和针对的重要因素，以预防心理困扰，以及该计划如何与他们的机构相关。
