Dörner Marc, von Känel Roland, König Noelle, Pazhenkottil Aju P, Altwegg Rahel, Nager Ladina, Attanasio Veronica, Guth Lisa, Zirngast Sina, Menzi Anna, Zuccarella-Hackl Claudia, Princip Mary
Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland.
German Center for Neurodegenerative Diseases (DZNE) within the Helmholtz Association, 39120 Magdeburg, Germany.
Healthcare (Basel). 2024 May 30;12(11):1118. doi: 10.3390/healthcare12111118.
Several studies suggested the efficacy of dispositional mindfulness and mindfulness-based interventions in reducing anxiety and depression in cardiovascular diseases. However, data on the impact of mindfulness on the psychological well-being of patients with an implantable cardioverter-defibrillator (ICD) are scarce. In this study, 422 patients with an ICD were prospectively recruited. Logistic regression was applied to determine associations between dispositional mindfulness (Freiburg Mindfulness Inventory), depression (Patient Health Questionnaire-8), anxiety (Generalized Anxiety Disorder-7 scale), and post-traumatic stress disorder (PTSD) symptoms (Post-Traumatic Stress Diagnostic Scale), adjusting for age, sex, educational status, number of ICD shocks after ICD implantation, and physical activity. The PROCESS regression path analysis modelling tool was used to identify indirect mediating effects of dispositional mindfulness on depression, anxiety, and PTSD symptoms and quality of life (QoL; EuroQol group 5-dimension questionnaire). Participants presented high baseline QoL (mean 1.06 to 1.72) and medium-high mindfulness scores (mean 40.85 points). Higher mindfulness scores were associated with lower levels of anxiety (OR 0.90, 95% CI 0.86 to 0.95, 0.001), depression (OR 0.93, 95% CI 0.88 to 0.98, = 0.006), and PTSD symptoms (OR 0.94, 95% CI 0.89 to 0.98, = 0.011). Furthermore, greater mindfulness partially mediated the relationship between anxiety (indirect effect 0.10, 95% CI 0.02 to 0.21), depression (indirect effect 0.08, 95% CI 0.01 to 0.17), or PTSD (indirect effect 0.04, 95% CI 0.01 to 0.17) as independent variables and the QoL as the dependent variable. This study suggests that greater dispositional mindfulness is associated with less anxiety, depression, and PTSD symptoms. Mindfulness might also increase the QoL in ICD patients by mitigating the impact of those with psychological distress.
多项研究表明，特质正念和基于正念的干预措施在减轻心血管疾病患者的焦虑和抑郁方面具有疗效。然而，关于正念对植入式心脏复律除颤器（ICD）患者心理健康影响的数据却很匮乏。在本研究中，前瞻性招募了422名ICD患者。应用逻辑回归来确定特质正念（弗莱堡正念量表）、抑郁（患者健康问卷-8）、焦虑（广泛性焦虑障碍-7量表）和创伤后应激障碍（PTSD）症状（创伤后应激障碍诊断量表）之间的关联，并对年龄、性别、教育程度、ICD植入后ICD电击次数和身体活动进行了调整。使用PROCESS回归路径分析建模工具来确定特质正念对抑郁、焦虑、PTSD症状和生活质量（QoL；欧洲五维健康量表）的间接中介效应。参与者呈现出较高的基线生活质量（平均1.06至1.72）和中高正念得分（平均40.85分）。较高的正念得分与较低水平的焦虑（OR 0.90，95%CI 0.86至0.95，P = 0.001）、抑郁（OR 0.93，9５%CI 0.88至0.98，P = 0.006）和PTSD症状（OR 0.94，95%CI 0.89至0.98，P = 0.011）相关。此外，更高的正念在一定程度上介导了以焦虑（间接效应0.10，95%CI 0.02至0.21）、抑郁（间接效应0.08，95%CI 0.01至0.17）或PTSD（间接效应0.04，95%CI 0.01至0.17）为自变量、生活质量为因变量之间的关系。本研究表明，更高的特质正念与较少的焦虑、抑郁和PTSD症状相关。正念还可能通过减轻心理困扰对ICD患者生活质量的影响来提高其生活质量。
