背景:关于心脏康复(CR)后心理健康改善的数据是矛盾的。目的是检查因急性冠状动脉综合征住院后入住我们康复中心的患者的心理和心理社会健康状况,在多学科CR之前和之后。
方法:通过36项简短表格调查(SF-36)在入院和出院时测量结果,症状检查表-90修订(SCL-90R),应对策略问卷(CSQ)和6分钟步行距离测试。将患者的健康状况与性别标准进行了比较,来自德国普通人群的年龄和合并症匹配数据。通过标准化平均差异(SMD)测量与规范的得分差异;通过标准化效应大小(ESs)量化健康变化。通过探索性因子分析量化了它们对综合评估的重要性。
结果:在随访的70例患者中(男性:79%;平均年龄:66.6岁),79%有≥3种合并症。在基线,SF-36物理功能(SMD=-0.75),角色物理(-0.90),社会功能(SMD=-0.44),和角色情绪(SMD=-0.45)明显差于常模。CR之后,几乎所有分数都显着提高了ES=0.23(SCL-90R人际关系敏感性)至1.04(SF-36身体功能)。健康状态和变化的最强因素(高达41.1%的解释方差)是心理健康领域,其次是功能和疼痛(高达26.3%)。
结论:在基线时报告了身体和心理社会健康的规范缺陷。CR之后,在后续行动中,所有分数,除了恐惧症,显着改善。生物心理社会健康的综合测量不应限于抑郁和焦虑,尤其是,躯体化和社会参与维度。
BACKGROUND: Data on mental health improvement after cardiac rehabilitation (CR) are contradictory. The aim was to examine the mental and psycho-social health of patients admitted to our rehabilitation center following hospital treatment for acute coronary syndrome, before and after multidisciplinary CR.
METHODS: Outcome was measured at admission and discharge by the 36-Item Short Form Survey (SF-36), the Symptom Checklist-90 Revised (SCL-90R), the Coping Strategy Questionnaire (CSQ) and the 6-min-walking distance test. The patients\' health status was compared with norms of sex-, age- and comorbidity-matched data from the German general population. Score differences from norms were measured by standardized mean differences (SMDs); health changes were quantified by standardized effect sizes (ESs). Their importance for comprehensive assessment was quantified by explorative factor analysis.
RESULTS: Of n = 70 patients followed-up (male: 79%; mean age: 66.6 years), 79% had ≥ 3 comorbidities. At baseline, SF-36 Physical functioning (SMD = - 0.75), Role physical (- 0.90), Social functioning (SMD = - 0.44), and Role emotional (SMD = - 0.45) were significantly worse than the
norm. After CR, almost all scores significantly improved by ES = 0.23 (SCL-90R Interpersonal sensitivity) to 1.04 (SF-36 Physical functioning). The strongest factor (up to 41.1% explained variance) for health state and change was the mental health domain, followed by function & pain (up to 26.3%).
CONCLUSIONS: Normative deficits in physical and psycho-social health were reported at baseline. After CR, at follow-up, all scores, except phobia, showed significant improvement. The comprehensive measurement of bio-psycho-social health should not be limited to depression and anxiety but include, especially, the somatization and social participation dimensions.