急性冠脈綜合征患者心理狀態(tài)與應對方式特點及其關系研究

1、急性冠脈綜合征患者心理狀態(tài)與應對方式特點及其關系研究    急性冠脈綜合征患者心理狀態(tài)與應對方式特點及其關系研究 Study of the Psychological Symptoms and Coping Style in Acute Coronary Syndrome Patients 【中文摘要】 目的:分析不同情況下急性冠脈綜合征(acute conoary syndrome,ACS)患者的心理狀態(tài)與應對方式特點及其相互關系,為制定提高患者心理狀態(tài)、應對能力的對策,促進其疾病的康復提供理論依據。方法:對95例ACS患者用癥狀自評量表(sympto

2、m check list 90,SCL-90)和醫(yī)學應對方式量表(medical coping modes questionnaire ,MCMQ)評價患者的心理狀態(tài)、應對方式。按ACS類型分為不穩(wěn)定型心絞痛( unstable angina , UA)組和急性心肌梗死( acute myocardial infarction ,AMI)組,合并高血壓組與不合并高血壓組,應用成組設計的t檢驗對其進行對照研究;應用PearsonS相關分析判別ACS患者的心理狀態(tài)和應對方式的相關性。結果:95例ACS患者的SCL-90總分及軀體化、抑郁、焦慮、敵對、恐怖、各因子得分高于常模組,而人際關系、偏執(zhí)分低

3、于常模組,強迫、精神病性兩因子得分較常模組無統(tǒng)計學差異;面對、回避應對方式得分低于常模組,屈服分高于常模組。女性較男性人際關系敏感、焦慮得分更高;男性更多采用面對應對方式,女性更多采用屈服應對方式。60歲以下患者較60歲以上患者抑郁、偏執(zhí)、精神病性得分更高,更多采用面對應對方式。高中以上學歷者較高中以下者SCL-90總分及強迫、人際關系、偏執(zhí)、精神病性得分更高,多采用面對與回避應對方式。離婚或喪偶比已婚者軀體化、焦慮、抑郁因子分及SCL-90總分高,更多采用屈服應對方式。不吸煙者比吸煙者人際關系敏感、精神病性得分較高,更多采用屈服應對方式。UA比AMI組SCL-90各因子得分及總分無統(tǒng)計學差異

4、,但AMI組更多采用屈服應對方式。合并高血壓組較不合并高血壓組SCL-90總分、軀體化、焦慮、恐怖因子得分更高,其應對方式無統(tǒng)計學差異。95例ACS患者的心理狀態(tài)總分與3種應對方式的相關性分析顯示,心理狀態(tài)總分與面對、回避、屈服3種應對方式均呈正相關。結論:ACS患者心理狀態(tài)較常模差,與疾病常模相比較少采用面對與回避應對方式,較多采用屈服應對方式。其心理狀態(tài)及應對方式受多種因素影響,高中以上學歷、離婚或喪偶、合并高血壓患者心理狀態(tài)較差;男性、60歲以下、高中以上患者更多采用面對應對方式,女性、離婚或喪偶、不吸煙者、AMI患者更多采用屈服的應對方式。心理狀態(tài)與應對方式之間存在正相關。 【英文摘要

5、】 Objective: To provide theory evidence for making treatment strategy for improving mental states and coping ability of acute coronary syndrome (ACS ) patients, we investigate the related factors and correlation of the psychological symptoms and coping style in ACS patients.Methods : 95 ACS patients

6、 were assessed by symptom check list 90(SCL-90)and medical coping modes questionnaire(MCMQ). The patients were divided into unstable angina pectoris (UAP) group and acute myocardial infarction (AMI) group. Data were analyzed by independent sample t test and Pearsons correlations.Results : Compare wi

7、th the ordinary mode,ACS 95 patients had significantly higher score of SCL-90 and more psychological symptoms such as somatic symptoms,depression,anxiety,hostility and fears .ACS patients had less symptoms of sensitive interpersonal relationship and paranoid than ordinary mode.There was no statistic

8、 difference of the score of obsession and psychosis between ordinary mode and ACS patients. Compare with ordinary mode,ACS patients had lower prevalence of "confrontation" and "avoidance" coping style and higher prevalence of "compromising "coping style.Female patients

9、had more sensitive inter- personal relationship and anxiety symptoms than male. Male had higher prevalence of "confrontation" coping style, however female had higher prevalence of "avoidance "coping style.Patients under sixty had more symptoms of depression, paranoid, psychosis a

10、nd higher prevalence of "confrontation" coping style than those over sixty. Patients with complete sec. education had significantly higher score of SCL-90 and more symptoms such as obsession,sensitive interpersonal relationship,paranoid and psycho- sis than those with incomplete sec. educa

11、tion.They also had higher pre- valence of "confrontation" and " avoidance " coping style. Compare with married patients,the widowed or divorced had significantly higher score of SCL-90 and more symptoms such as somatic symptoms, depression and anxiety, they had higher prevalence

12、of " com- promising " coping style . As for non-smoker,they had more symptoms of sensitive interpersonal rela- tionship and paranoid and higher prevalence of "compromising" coping style than smoker. There were no statistic difference of the psychological symptoms between UAP and

13、AMI patients, but AMI patients had higher prevalence of " compromising " coping style .Patients with hypertension had higher score of SCL-90 and more symptoms of somatic symptoms, anxiety and fear than those without. Hypertension had no effect on coping style.There was a positive correlati

14、on between psychological symptoms and the three kind of coping style in ACS patients.Conclusion: The psychological states of ACS patients were worse than ordinary mode. They had higher prevalence of "compromising" coping style and lower prevalence of "confrontation","avoidan

15、ce" coping style. There are many related factors affect psychological symptoms and coping style of ACS patients. Patients with complete sec. education, widowed or divorced, or combine hypertension may have bad psychological states. Male, age under sixty or with complete sec. education had high

16、prevalence of "conf- rontation" coping style. Female, patients with AMI or widowed or divorced, or non-smoker had high prevalence of " compromising " coping style . Psychological symptoms had a positive correlation to coping style in ACS patents.  【中文關鍵詞】 急性冠脈綜合征; 心理狀態(tài); 應對方式 【英文關鍵詞】 Acute coronary syndrome(ACS) ; Psychological symptoms; Coping style   急性冠脈綜合征患者心理狀態(tài)與