Eilerts Anna-Lisa, Schröer Sarah, Wissen Sarah, Mayer-Berger Wolfgang, Pieper Claudia
Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universitätsklinikum Essen, Deutschland.
Klinik Roderbirken der Deutschen Rentenversicherung Rheinland, Leichlingen, Deutschland.
Rehabilitation (Stuttg). 2022 Jun;61(3):162-169. doi: 10.1055/a-1642-3450. Epub 2021 Nov 12.
The psychosocial care of cardiac patients is becoming increasingly important. In inpatient cardiac rehabilitation, patients should be ideally screened for psychosocial risk factors and given psychological support. Heart-focused anxiety can significantly impair quality of life and subsequently influence prognosis of the course of the disease as well as social and occupational participation. Due to the difference between reported prevalence of heart-focused anxiety and the observed lower rate of patients expressing need for psychological support, the authors assumed that some patients do not express their need for psychological support. Therefore, aim of the study was to identify these patients through a simple screening instrument in order to offer them appropriate psychological support and consequently to maintain rehabilitation goals, including ability to work.
We conducted a cross-sectional study at an inpatient cardiac rehabilitation center, Roderbirken, Leichlingen, Germany. Patients completed a standardised questionnaire, consisting of the Cardiac Anxiety Questionnaire, the Hospital Anxiety and Depression Scale and Scale I of the Screening Instrument Work and Occupation. Data were analyzed using descriptive statistics and logistic regression analysis. Ethical approval was obtained.
Finally, 507 patients were included in the analysis (82.6% men, mean age 54.4±7.1 years). Of these, 40.0% expressed need for psychological support. Prevalence of heart-focused anxiety was 15.7%; among them significantly more patients expressed need for psychological support (59.0 vs. 41.0%; p<0.05). Also patients with mental disorders expressed need for psychological support (57.6 vs. 0.7%; p<0.05). Subjective assessment of early retirement was associated with heart-focused anxiety and with depressive symptoms (both p<0.001) as well as education and employment status.
Based on the results of the self-assessment instruments as well as the socioeconomic and clinical patient characteristics, possible indicators of subjective occupational prognosis can be derived.
An screening through Hospital Anxiety and Depression Scale can facilitate target achievement of return to work in cardiac rehabilitation.
心脏病患者的心理社会护理正变得越来越重要。在住院心脏康复中，理想情况下应对患者进行心理社会风险因素筛查并给予心理支持。专注于心脏的焦虑会显著损害生活质量，并随后影响疾病进程的预后以及社会和职业参与。由于报告的专注于心脏的焦虑患病率与观察到的表达心理支持需求的患者较低比例之间存在差异，作者推测一些患者没有表达他们对心理支持的需求。因此，本研究的目的是通过一种简单的筛查工具识别这些患者，以便为他们提供适当的心理支持，从而维持康复目标，包括工作能力。
我们在德国莱希林根罗德比尔肯的一家住院心脏康复中心进行了一项横断面研究。患者完成了一份标准化问卷，包括心脏焦虑问卷、医院焦虑抑郁量表和工作与职业筛查工具量表I。使用描述性统计和逻辑回归分析对数据进行分析。获得了伦理批准。
最终，507名患者纳入分析（82.6%为男性，平均年龄54.4±7.1岁）。其中，40.0%表示需要心理支持。专注于心脏的焦虑患病率为15.7%；其中明显更多的患者表示需要心理支持（59.0%对41.0%；p<0.05）。患有精神障碍的患者也表示需要心理支持（57.6%对0.7%；p<0.05）。对提前退休的主观评估与专注于心脏的焦虑、抑郁症状（均p<0.001）以及教育和就业状况相关。
基于自我评估工具的结果以及社会经济和临床患者特征，可以得出主观职业预后的可能指标。
通过医院焦虑抑郁量表进行筛查可以促进心脏康复中恢复工作这一目标的实现。
