冠状动脉粥样硬化性心脏病患者及其家属在手术前后心理状态的对比研究

doi:10.3969/j.issn.1006-7795.2019.01.020

首都医科大学学报 ›› 2019, Vol. 40 ›› Issue (1): 112-118.doi: 10.3969/j.issn.1006-7795.2019.01.020

冠状动脉粥样硬化性心脏病患者及其家属在手术前后心理状态的对比研究

蒲连美¹, 李瑛², 李红³, 李响¹, 阮杨³, 韩福生¹, 田春营¹, 金泽宁³

1. 首都医科大学附属北京安贞医院急诊危重症中心, 北京 100029;
2. 首都医科大学附属北京儿童医院精神科国家儿童医学中心, 北京 100045;
3. 首都医科大学附属北京天坛医院心内科, 北京 100070

收稿日期:2018-05-25 出版日期:2019-01-21 发布日期:2019-01-23
通讯作者: 金泽宁 E-mail:jinzening33@126.com
基金资助:
国家自然科学基金（81570323）。

Course of depression and anxiety in patients undergoing percutaneous coronary intervention and their family caregivers

Pu Lianmei¹, Li Ying², Li Hong³, Li Xiang¹, Ruan Yang³, Han Fusheng¹, Tian Chunying¹, Jin Zenning³

1. Department of Emergency Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China;
2. Department of Psychiatry, Beijing Children's Hospital, Capital Medical University;National Center for Children Healthy, Beijing 100045, China;
3. Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China

Received:2018-05-25 Online:2019-01-21 Published:2019-01-23
Supported by:
This study was supported by National Natural Science Foundation of China (81570323).

摘要/Abstract

摘要： 目的本研究旨在调查住院冠状动脉粥样硬化性心脏病（以下简称冠心病）患者及其家属在经皮冠状动脉支架置入（percutaneous coronary intervention，PCI）术前、后的焦虑和/或抑郁状态的发生情况及变化特点。方法选取拟行PCI术的住院冠心病患者和与陪同就诊的家属共50对。在术前1 d、出院当天及术后1个月分别进行抑郁自评量表（Self-rating Depression Scale，SDS）和焦虑自评量表（Self-rating Anxiety Scale，SAS）评估。并增设开放性问题补充了解患者及其家属的关注点。结果在术前、出院当天及术后1月共3个时间点，有、无心理困扰的家庭，患者及家属的SDS和SAS评分呈现出4种不同的变化特点，无心理困扰的家庭比例逐渐升高，分别占42%、52%及54%；存在心理困扰的家庭比例在出院当天略降低（占8%），术前（占12%）和术后（占14%）相似；存在心理困扰的家属比例逐渐降低，分别占30%、26%及18%；存在心理困扰的患者比例未见明显变化，分别占16%、14%及14%，但上述变化的差异无统计学意义（P值为0.437~0.948）。随着时间的变化，家属SDS和SAS平均值逐渐减低，而患者SDS和SAS平均值在术前和出院1个月时均较高，但患者和家属上述变化的差异均无统计学意义（P值为0.113~0.610）。存在心理困扰的研究对象共同的主要症状为睡眠障碍。术前患者及其家属最关系的焦点均是手术相关问题；在术后1个月时，患者最为担心的方面涉及病情、药物及工作和/或生活，家属最关心患者的手术效果。结论术前存在焦虑或抑郁状态的冠心病患者和家庭，其心理状态在PCI术后未见明显改善趋势。

关键词: 经皮冠状动脉支架置入术, 患者, 家属, 抑郁, 焦虑

Abstract: Objective To follow up the course of anxiety and depression in patients undergoing percutaneous coronary intervention (PCI) and their family caregivers (FCs). Methods Fifty dyads of patients undergoing PCI and their FCs completed self-report questionnaires at three timepoints (before PCI, at discharge, and 1 month after discharge). Depression and anxiety levels were measured by Self-rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS). Participants were also asked an open-ended question about their most important current concerns at each interview. Results There were four different characteristics among different groups according to SDS and SAS scores. The percentages of families without psychological distress increased gradually from pre-PCI to 1 month after discharge, for 42%,52% and 54%, respectively. The percentages of families with psychological distress were low at discharge (8%), but were high and similar between before-PCI(12%) and 1 month post-PCI (14%). The percentages of FCs with psychological distress reduced over time for 30%, 26% and 18%, respectively.There were not significant changes in the percentages of patients with psychological distress (range 14%-16%). With the time change, the average SDS and SAS scores of FCs decreased, while those of patients were higher before PCI (12%) and 1 month after discharge than at discharge.The above results were not significant difference (P>0.05). The main symptom complained was sleep disorder in participants who experienced psychological distress. Major concerns of patients and FCs were similar before PCI, but became different after discharge. Conclusion Our study reveals that the overall psychological state of patients and their families are not significantly improved after discharge if they had anxiety or depression before PCI.

Key words: percutaneous coronary intervention, patient, family caregiver, depression, anxiety

中图分类号:

R541.4

蒲连美, 李瑛, 李红, 李响, 阮杨, 韩福生, 田春营, 金泽宁. 冠状动脉粥样硬化性心脏病患者及其家属在手术前后心理状态的对比研究[J]. 首都医科大学学报, 2019, 40(1): 112-118.

Pu Lianmei, Li Ying, Li Hong, Li Xiang, Ruan Yang, Han Fusheng, Tian Chunying, Jin Zenning. Course of depression and anxiety in patients undergoing percutaneous coronary intervention and their family caregivers[J]. Journal of Capital Medical University, 2019, 40(1): 112-118.

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冠状动脉粥样硬化性心脏病患者及其家属在手术前后心理状态的对比研究

Course of depression and anxiety in patients undergoing percutaneous coronary intervention and their family caregivers

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