Savio Marlyn Thomas, Hariharan Meena
Freelance Psychologist.
Professor, Centre for Health Psychology, University of Hyderabad, India.
Health Psychol Res. 2020 Dec 30;8(3):8887. doi: 10.4081/hpr.2020.8887.
The study examined the impact of two types of psychosocial intervention on prognosis and psychological distress of patients subjected to Coronary Artery Bypass Grafting (CABG), and investigated whether such impact was direct or mediated. A sample of 300 participants (243 men and 57 women; mean age: 56.1 years) was recruited into three groups. One group received a unique psycho-educational intervention called Programme for Affective and Cognitive Education (PACE), the second group was given a Relaxation intervention (Guided Imagery), and the third group had only standard medical treatment (Control). The PACE and Relaxation interventions were administered to patients alongside standard treatment a day before CABG as well as a day before discharge from hospital. Prognosis was assessed six weeks after discharge. Psychological distress was measured at baseline, week after discharge, and six weeks after discharge. Analyses of variance revealed a significant effect of groups on prognosis and a significant group × time interaction for psychological distress. The highest prognosis after CABG and the lowest psychological distress were found in the PACE group. Path analyses indicated that the PACE and Relaxation interventions negatively impacted psychological distress which in turn predicted higher prognosis. Only the PACE intervention additionally had a positive direct impact on prognosis. Both psychosocial interventions helped enhance the prognosis of patients after CABG primarily by reducing psychological distress. PACE emerged as a more effective intervention than Relaxation.
该研究考察了两种心理社会干预措施对接受冠状动脉搭桥术（CABG）患者的预后及心理困扰的影响，并探究这种影响是直接的还是通过中介作用产生的。研究招募了300名参与者（243名男性和57名女性；平均年龄：56.1岁），分为三组。一组接受一种名为情感与认知教育计划（PACE）的独特心理教育干预，第二组接受放松干预（引导式意象），第三组仅接受标准医疗治疗（对照组）。PACE和放松干预在CABG手术前一天以及出院前一天与标准治疗同时给予患者。出院六周后评估预后情况。在基线、出院后一周和出院六周时测量心理困扰程度。方差分析显示，不同组对预后有显著影响，且在心理困扰方面存在显著的组×时间交互作用。PACE组在CABG术后的预后最佳，心理困扰程度最低。路径分析表明，PACE和放松干预对心理困扰有负面影响，而心理困扰反过来又预示着更好的预后。只有PACE干预对预后有额外的直接积极影响。两种心理社会干预措施主要通过减轻心理困扰来帮助改善CABG术后患者的预后。结果显示，PACE比放松干预更有效。
