应对策略和心理状态在房颤患者疾病感知与生活质量间的中介效应：一项横断面研究。
Mediating effect of coping strategy and psychological status between illness perception and quality of life among patients with atrial fibrillation: a cross-sectional study.
机构信息
Department of Medical Psychology, Peking University People's Hospital, Beijing, China.
出版信息
BMC Cardiovasc Disord. 2024 Sep 19;24(1):504. doi: 10.1186/s12872-024-04176-4.
BACKGROUND
This study investigated the mediating effects of coping strategies and psychological status on the relationship between illness perception and health-related quality of life (HRQoL) among patients with atrial fibrillation (AF).
METHODS
This cross-sectional study enrolled 178 patients with AF who were admitted to a tertiary hospital in Beijing City in mainland from March 2020 and June 2022. Assessments were made for HRQoL using the Short Form Health Survey depressive symptoms using the Patient Health Questionnaire-9, anxiety using the Generalized Anxiety Disorder-7 (GAD-7), illness perception using the Brief Illness Perception Questionnaire (BIPQ), AF symptoms using the Atrial Fibrillation Severity Scale (AFSS), and coping strategies using the Brief-COPE Scale.
RESULTS
Significant correlations were observed between illness perception, emotional variables, coping strategies, and HRQoL scores. The regression analysis found that BIPQ, GAD, Maladaptive coping and Problem-focused coping are significant predictors of PCS (F = 20.906, R = 0.326, p < 0.01) and MCS (F = 31.24, R = 0.419, p < 0.01). Bootstrap samples were used to conduct mediation analysis. The indirect effects of GAD-7 and Problem-focused coping (PC) on the impact of BIPQ on QoL were significant. GAD accounted for 13.2-19.3% of the variance in the total effect across different models, while PC accounted for 22.1-25.8%. The results also indicated a significant chain effect in the illness percepitong-anxiety-coping style-QoL model, which can explain 4.3-10.2% of the total effect, respectively.
CONCLUSIONS
The perception of illness significantly influenced HRQoL in patients with AF, as mediated by emotional symptoms and coping strategies. This highlights the importance of anxiety and problem-focused coping mechanisms. These findings underscore the need for a holistic, patient-centered approach to AF management that incorporates emotional well-being and coping strategies.
TRIAL REGISTRATION
Retrospectively registered with ClinicalTrials.gov (NCT05974098). The date of registration: 1 August 2023.
背景
本研究旨在探讨应对策略和心理状态在心房颤动（AF）患者的疾病感知与健康相关生活质量（HRQoL）之间的关系中的中介作用。
方法
本横断面研究纳入了 2020 年 3 月至 2022 年 6 月期间在北京一家三级医院就诊的 178 例 AF 患者。使用简短健康调查抑郁症状量表（Patient Health Questionnaire-9）评估 HRQoL，使用广泛性焦虑障碍-7 量表（Generalized Anxiety Disorder-7，GAD-7）评估焦虑，使用简要疾病感知问卷（Brief Illness Perception Questionnaire，BIPQ）评估疾病感知，使用心房颤动严重程度量表（Atrial Fibrillation Severity Scale，AFSS）评估 AF 症状，使用应对策略量表（Brief-COPE Scale）评估应对策略。
结果
疾病感知、情绪变量、应对策略和 HRQoL 评分之间存在显著相关性。回归分析发现，BIPQ、GAD、适应性应对和问题导向应对是 PCS（F=20.906，R²=0.326，p<0.01）和 MCS（F=31.24，R²=0.419，p<0.01）的显著预测因子。采用 Bootstrap 样本进行中介分析。GAD-7 和问题导向应对（PC）对 BIPQ 对生活质量影响的间接效应显著。在不同模型中，GAD 解释了总效应的 13.2-19.3%，而 PC 解释了 22.1-25.8%。研究结果还表明，在疾病感知-焦虑-应对方式-QoL 模型中存在显著的连锁效应，分别可以解释总效应的 4.3-10.2%。
结论
疾病感知显著影响 AF 患者的 HRQoL，其机制是通过情绪症状和应对策略的中介作用。这突出了焦虑和问题导向应对机制的重要性。这些发现强调了需要采取整体的、以患者为中心的方法来管理 AF，包括情绪健康和应对策略。
试验注册
回顾性地在 ClinicalTrials.gov 注册（NCT05974098）。注册日期：2023 年 8 月 1 日。
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