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Abstract：
BACKGROUND: Cardiac rehabilitation (CR) participation after percutaneous coronary intervention (PCI) for coronary heart disease lowers the disease burden and risk of recurrent cardiac events. Examining psychological factors may improve post-PCI health behavior adherence.
OBJECTIVE: To determine whether psychological factors are associated with post-PCI health behavior adherence, and the role of CR participation.
METHODS: Data from 1,682 patients (22.1% female, Mage = 64.0, SDage = 10.5 years) from the THORESCI cohort were included. Adjusted mixed models were used to examine associations between psychological factors and the 1-year course of health behaviors, using interactions to test for moderation by CR participation.
RESULTS: Psychological factors were associated with the trajectories of adherence to medical advice, exercise, and diet. The strongest association found was between optimism and the trajectory of dietary adherence (B: = -0.09, p = .026). Patients with high optimism levels had a worse trajectory of dietary adherence compared to patients with low to middle optimism levels. Participation in CR buffered the associations of high anxiety, pessimism, and low to middle resilience, but strengthened the associations of high stress in the past year with the probability of smoking.
CONCLUSIONS: Psychological factors are associated with post-PCI health behavior adherence, but the pattern of associations is complex. Patients with high levels of anxiety, pessimism, and low to middle resilience levels may disproportionately benefit from CR. Cardiac rehabilitation programs could consider this to improve post-PCI health behavior adherence.
UNASSIGNED: NCT02621216.
For patients with coronary heart disease who have undergone percutaneous coronary intervention (PCI), participating in cardiac rehabilitation (CR) reduces the disease burden and the risk of future cardiac events. However, adherence to the health behaviors targeted in CR could be improved. Using data from 1,682 patients included in the THORESCI study, we explored whether psychological factors could predict health behavior adherence and the role of participation in CR. Results revealed that psychological factors were linked to adherence to medical advice, exercise, and diet. Overall, patients with low to moderate optimism levels exhibited more favorable changes in healthy dietary habits than patients with high levels of optimism. Participation in CR made the link between high anxiety, pessimism, low to moderate resilience, and lower adherence to health behaviors less strong. Cardiac rehabilitation programs could use these results to enhance the health behavior adherence of patients who have undergone PCI.
OBJECTIVE: To determine whether psychological factors are associated with post-PCI health behavior adherence, and the role of CR participation.
METHODS: Data from 1,682 patients (22.1% female, Mage = 64.0, SDage = 10.5 years) from the THORESCI cohort were included. Adjusted mixed models were used to examine associations between psychological factors and the 1-year course of health behaviors, using interactions to test for moderation by CR participation.
RESULTS: Psychological factors were associated with the trajectories of adherence to medical advice, exercise, and diet. The strongest association found was between optimism and the trajectory of dietary adherence (B: = -0.09, p = .026). Patients with high optimism levels had a worse trajectory of dietary adherence compared to patients with low to middle optimism levels. Participation in CR buffered the associations of high anxiety, pessimism, and low to middle resilience, but strengthened the associations of high stress in the past year with the probability of smoking.
CONCLUSIONS: Psychological factors are associated with post-PCI health behavior adherence, but the pattern of associations is complex. Patients with high levels of anxiety, pessimism, and low to middle resilience levels may disproportionately benefit from CR. Cardiac rehabilitation programs could consider this to improve post-PCI health behavior adherence.
UNASSIGNED: NCT02621216.
For patients with coronary heart disease who have undergone percutaneous coronary intervention (PCI), participating in cardiac rehabilitation (CR) reduces the disease burden and the risk of future cardiac events. However, adherence to the health behaviors targeted in CR could be improved. Using data from 1,682 patients included in the THORESCI study, we explored whether psychological factors could predict health behavior adherence and the role of participation in CR. Results revealed that psychological factors were linked to adherence to medical advice, exercise, and diet. Overall, patients with low to moderate optimism levels exhibited more favorable changes in healthy dietary habits than patients with high levels of optimism. Participation in CR made the link between high anxiety, pessimism, low to moderate resilience, and lower adherence to health behaviors less strong. Cardiac rehabilitation programs could use these results to enhance the health behavior adherence of patients who have undergone PCI.
摘要：
背景：冠心病经皮冠状动脉介入治疗（PCI）后参与心脏康复（CR）可降低疾病负担和心脏事件复发的风险。检查心理因素可能会改善PCI术后健康行为的依从性。
目的：确定心理因素是否与PCI术后健康行为依从性相关，以及CR参与的作用。
方法：数据来自1,682名患者（22.1%为女性，包括来自THORESCI队列的Mage=64.0，SDage=10.5岁）。调整后的混合模型用于检查心理因素与1年健康行为之间的关联。使用互动来测试CR参与的适度性。
结果：心理因素与坚持医疗建议的轨迹有关，锻炼,和饮食。发现的最强关联是乐观与饮食依从性的轨迹（B：=-0.09，p=0.026）。与低至中乐观水平的患者相比，乐观水平高的患者的饮食依从性轨迹较差。参与CR缓冲了高度焦虑的关联，悲观,和低到中等的韧性，但加强了过去一年中高压力与吸烟概率的关联。
结论：心理因素与PCI术后健康行为依从性相关，但是联想的模式很复杂。高度焦虑的患者，悲观,低到中等的复原力水平可能不成比例地受益于CR。心脏康复计划可以考虑这一点，以改善PCI后的健康行为依从性。
■NCT02621216。
对于接受经皮冠状动脉介入治疗（PCI）的冠心病患者，参与心脏康复(CR)可降低疾病负担和未来心脏事件的风险.然而,可以提高对CR目标健康行为的依从性。使用THORESCI研究中包含的1,682名患者的数据，我们探讨了心理因素是否可以预测健康行为依从性以及参与CR的作用。结果显示，心理因素与坚持医疗建议有关，锻炼,和饮食。总的来说,与乐观程度高的患者相比,乐观程度低至中等的患者在健康饮食习惯方面表现出更有利的改变.参与CR使高度焦虑，悲观,低到中等的韧性，对健康行为的依从性较低。心脏康复计划可以利用这些结果来增强接受PCI的患者的健康行为依从性。
目的：确定心理因素是否与PCI术后健康行为依从性相关，以及CR参与的作用。
方法：数据来自1,682名患者（22.1%为女性，包括来自THORESCI队列的Mage=64.0，SDage=10.5岁）。调整后的混合模型用于检查心理因素与1年健康行为之间的关联。使用互动来测试CR参与的适度性。
结果：心理因素与坚持医疗建议的轨迹有关，锻炼,和饮食。发现的最强关联是乐观与饮食依从性的轨迹（B：=-0.09，p=0.026）。与低至中乐观水平的患者相比，乐观水平高的患者的饮食依从性轨迹较差。参与CR缓冲了高度焦虑的关联，悲观,和低到中等的韧性，但加强了过去一年中高压力与吸烟概率的关联。
结论：心理因素与PCI术后健康行为依从性相关，但是联想的模式很复杂。高度焦虑的患者，悲观,低到中等的复原力水平可能不成比例地受益于CR。心脏康复计划可以考虑这一点，以改善PCI后的健康行为依从性。
■NCT02621216。
对于接受经皮冠状动脉介入治疗（PCI）的冠心病患者，参与心脏康复(CR)可降低疾病负担和未来心脏事件的风险.然而,可以提高对CR目标健康行为的依从性。使用THORESCI研究中包含的1,682名患者的数据，我们探讨了心理因素是否可以预测健康行为依从性以及参与CR的作用。结果显示，心理因素与坚持医疗建议有关，锻炼,和饮食。总的来说,与乐观程度高的患者相比,乐观程度低至中等的患者在健康饮食习惯方面表现出更有利的改变.参与CR使高度焦虑，悲观,低到中等的韧性，对健康行为的依从性较低。心脏康复计划可以利用这些结果来增强接受PCI的患者的健康行为依从性。
