Shi Zhuofei, Xia Kun, Li Jianchao, Lu Jianqi, Lu Hongping, Li Yanli, Zhang Jifeng, Chen Qilan, Liu Jing, Ding Rongjing
Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Beijing Chaoyang Hospital Affiliated to Capital Medical University Heart Centre, Beijing, China.
J Glob Health. 2025 Jan 31;15:04019. doi: 10.7189/jogh.15.04019.
Psychological distress, such as depression and anxiety, impacts cardiovascular disease (CVD) prognosis and management. Illness comprehension is essential for effective treatment, but biases can lead to suboptimal outcomes. We explored psycho-cardiovascular disease (PCD) patient characteristics, with a specific focus on comprehension biases and treatment choices from patients' perspectives in China, to improve management strategies.
We enrolled 864 PCD patients in Chinese hospitals across 11 provinces. Tools included the seven-item General Anxiety Disorder scale, the nine-item Patient Health Questionnaire, and a self-designed PCD illness comprehensibility survey. We used χ test, univariate, and multivariate logistic regression to examine patient characteristics.
Of 834 enrolled PCD patients, over 90% experienced mild to moderate anxiety and depression, yet less than 10% received treatment. 52.90% of patients had high illness comprehension. Among the high comprehension group, there were fewer labourers (19.30% vs. 26.40%; P < 0.05), fewer older individuals (39.20% vs. 46.90%; P < 0.05), and those with lower household income (15.60% vs. 30.50%; P < 0.05). A greater proportion of those in the high comprehension group lacked insurance (17.50% vs. 10.00%; P < 0.05), and they were more highly educated (42.90% vs. 32.10% with a college education). Additionally, more patients in the high comprehension group frequently received psychological consultation (24.00% vs. 5.10%; P < 0.05) and therapy (7.70% vs. 2.30%; P < 0.05). These patient groups preferred tertiary hospitals (71.66% vs. 63.33%; P < 0.05) and psycho-cardiovascular clinics (40.14% vs. 25.90%; P < 0.05). In comparison, low comprehension patients prioritised cost (32.65% vs. 46.41%; P < 0.05) and favoured a transition to community hospitals (16.55% vs. 25.38%; P < 0.05).
More than 90% of PCD patients in Chinese CVD departments experience mild to moderate anxiety and depression with low treatment rates. Different illness comprehension levels are associated with variations in treatment willingness, considerations, health care preferences, medication choices, and illness knowledge acquisition methods.
心理困扰，如抑郁和焦虑，会影响心血管疾病（CVD）的预后和管理。疾病认知对于有效治疗至关重要，但认知偏差可能导致治疗效果欠佳。我们探讨了心理-心血管疾病（PCD）患者的特征，特别关注中国患者在认知偏差和治疗选择方面的观点，以改进管理策略。
我们在11个省份的中国医院招募了864名PCD患者。使用的工具包括七项广泛性焦虑障碍量表、九项患者健康问卷以及自行设计的PCD疾病可理解性调查问卷。我们使用χ检验、单因素和多因素逻辑回归来研究患者特征。
在纳入的834名PCD患者中，超过90%经历了轻度至中度的焦虑和抑郁，但接受治疗的患者不到10%。52.90%的患者疾病认知水平较高。在高认知组中，劳动者较少（19.30%对26.40%；P<0.05），老年人较少（39.20%对46.90%；P<0.05），家庭收入较低的人较少（15.60%对30.50%；P<0.05）。高认知组中未参保的比例更高（17.50%对10.00%；P<0.05），且受教育程度更高（大学学历者占42.90%对32.10%）。此外，高认知组中更多患者经常接受心理咨询（24.00%对5.10%；P<0.05）和治疗（7.70%对2.30%；P<0.05）。这些患者群体更倾向于选择三级医院（71.66%对63.33%；P<0.05）和心理-心血管门诊（40.14%对25.90%；P<0.05）。相比之下,低认知患者更看重费用（32.65%对46.41%；P<0.05），并倾向于转诊至社区医院（16.55%对25.38%；P<0.05）。
中国心血管科超过90%的PCD患者经历轻度至中度焦虑和抑郁，治疗率较低。不同的疾病认知水平与治疗意愿、考量因素、医疗保健偏好、药物选择以及疾病知识获取方式的差异相关。
