Denollet J
University Hospital of Antwerp, Belgium.
Psychosom Med. 1994 Sep-Oct;56(5):463-74. doi: 10.1097/00006842-199409000-00012.
Research on coronary heart disease (CHD) lacks sensitive outcome measures. Health complaints, although subjective in nature, may provide information on the degree of recovery from CHD. The purpose of Study 1 was to identify common health complaints in a group of 535 men (mean age, 57.5 years) with CHD. In the weeks after a coronary event, they frequently reported somatic (e.g., chest pain, dyspnea, fatigue, sleep problems) and cognitive (e.g., concern about health and functional status) health complaints. Statistical analyses produced the Health Complaints Scale (HCS), which comprises 12 somatic and 12 cognitive complaints. Confirmatory factor analysis provided evidence for the model undergirding the HCS, and the somatic and cognitive scales of the HCS were found to have high internal consistency (alpha > or = .89), adequate test-retest reliability (r > or = .69), and good construct validity. Study 2 provided evidence for the idea that the HCS can be distinguished from standard scales of psychopathology. Statistical analyses in 266 men with CHD indicated that, compared to symptoms of psychopathology, the HCS scales displayed discrete factor loadings as well as higher scores at baseline and a normal clustering of scores. Important to note, HCS scores decreased in 60 subjects participating in cardiac rehabilitation (p < .0001) but not in 60 control subjects. Although research should not disregard psychological biases on symptom reporting, it is argued that health complaints need to be accurately assessed in CHD patients.
关于冠心病（CHD）的研究缺乏敏感的结局指标。健康主诉虽然本质上是主观的，但可能提供有关冠心病恢复程度的信息。研究1的目的是确定一组535名冠心病男性患者（平均年龄57.5岁）中常见的健康主诉。在冠心病发作后的几周内，他们经常报告躯体方面的（如胸痛、呼吸困难、疲劳、睡眠问题）和认知方面的（如对健康和功能状态的担忧）健康主诉。统计分析得出了健康主诉量表（HCS），该量表包括12项躯体主诉和12项认知主诉。验证性因素分析为支撑HCS的模型提供了证据，并且发现HCS的躯体量表和认知量表具有较高的内部一致性（α≥0.89）、足够的重测信度（r≥0.69）和良好的结构效度。研究2为HCS可与精神病理学标准量表区分开来的观点提供了证据。对266名冠心病男性患者的统计分析表明，与精神病理学症状相比，HCS量表显示出离散的因素负荷以及在基线时更高的分数和分数的正常聚类。需要注意的是，60名参加心脏康复的受试者的HCS分数下降了（p<0.0001），但60名对照受试者的分数没有下降。虽然研究不应忽视症状报告中的心理偏差，但有人认为需要对冠心病患者的健康主诉进行准确评估。
