Denollet J
Centre of Cardiac Rehabilitation, University Hospital of Antwerp, Belgium.
Psychol Med. 1993 Feb;23(1):111-21. doi: 10.1017/s0033291700038903.
Evidence indicates that emotional distress has a long-term impact on morbidity and mortality in patients with coronary heart disease (CHD), and that symptoms of depression, fatigue, and reduced energy may identify high-risk patients. This study was designed to: (1) devise a sound and practical measure of emotional distress in CHD patients; (2) examine the relationship between emotional distress and fatigue following CHD; and (3) examine changes in emotional distress as a function of cardiac rehabilitation. A sample of 478 men with CHD (mean age = 57.8 +/- 8.7 y) filled out questionnaires 3-6 weeks following a myocardial infarction (N = 110), bypass surgery (N = 302), or coronary angioplasty (N = 66). Statistical analyses of 56 Dutch mood terms were used to produce the 20-item Global Mood Scale (GMS) which measures negative affect (characterized by fatigue and malaise), as well as positive affect (characterized by energy and sociability), in patients with CHD. The GMS was found to be a reliable scale (alpha > 0.90; r > 0.55 over a 3-month period), and correlations with existing measures of emotional functioning and self-deception indicated its convergent and discriminant validity. Most importantly, fatigue was not related to cardiorespiratory fitness in a subset of 140 patients, but clearly was associated with negative affect. Consistent with the self-efficacy model, scores on the GMS mood scales improved significantly as a function of rehabilitation (P < 0.0001). Although symptoms of emotional distress are easily explained away by situational factors, previous research suggests that failure to recognize the clinical significance of these symptoms in CHD patients may result in the delay of much needed intervention. The current findings suggest that the GMS is a theoretically and psychometrically sound measure of emotional distress in CHD patients, and that this scale is sufficiently sensitive to assess change.
有证据表明，情绪困扰对冠心病（CHD）患者的发病率和死亡率有长期影响，而且抑郁、疲劳和精力下降等症状可能有助于识别高危患者。本研究旨在：（1）设计一种合理且实用的方法来测量冠心病患者的情绪困扰；（2）研究冠心病后情绪困扰与疲劳之间的关系；（3）研究情绪困扰随心脏康复的变化情况。478名冠心病男性患者（平均年龄 = 57.8 ± 8.7岁）在心肌梗死（N = 110）、搭桥手术（N = 302）或冠状动脉成形术（N = 66）后3 - 6周填写了问卷。对56个荷兰语情绪词汇进行统计分析，得出了20项全球情绪量表（GMS），该量表用于测量冠心病患者的消极情绪（以疲劳和不适为特征）以及积极情绪（以精力和社交能力为特征）。结果发现GMS是一个可靠的量表（α > 0.90；3个月内r > 0.55），与现有情绪功能和自我欺骗测量方法的相关性表明了其收敛效度和区分效度。最重要的是，在140名患者的子集中，疲劳与心肺功能无关，但明显与消极情绪相关。与自我效能模型一致，GMS情绪量表的得分随着康复显著改善（P < 0.0001）。虽然情绪困扰症状很容易用情境因素来解释，但先前的研究表明，未能认识到这些症状在冠心病患者中的临床意义可能会导致急需的干预措施延迟。目前的研究结果表明，GMS是一种在理论和心理测量学上都合理的测量冠心病患者情绪困扰的方法，并且该量表对评估变化足够敏感。
