心房颤动患者及家属焦虑的相关因素分析

Analysis of factors associated with anxiety in patients with atrial fibrillation and their caregivers

目的分析心房颤动患者及其家属发生焦虑的相关因素。方法回顾性纳入2020年9月至2021年3月就诊于首都医科大学附属北京安贞医院的心房颤动住院患者,及每例患者的1名家属。收集患者及其家属的基本资料,并应用广泛性焦虑障碍量表(GAD‑7)评估患者及家属的焦虑情况。本研究最终入选374例心房颤动患者及374名家属。采用多因素logistic回归模型分析患者及家属发生焦虑的相关因素。结果患者的年龄为(58.3±10.6)岁,女性为124例(33.2%);家属的年龄(53.6±11.6)岁,女性247名(66%)。69例(18.4%)患者及38名(10.2%)家属存在轻度焦虑(GAD‑7:5~9分),13例(3.5%)患者及9名(2.4%)家属存在中度及以上焦虑(GAD‑7:10~21分)。多因素分析显示,心房颤动患者焦虑的相关因素包括欧洲心律协会(EHRA)评分≥3(OR=1.73,95%CI:1.03~2.89,P=0.039)及女性(OR=1.90,95%CI:1.06~3.40,P=0.032),而患者EHRA评分≥3(OR=2.11,95%CI:1.05~4.24,P=0.036)、患者焦虑(OR=2.76,95%CI:1.36~5.60,P=0.005)则家属发生焦虑的可能性更高。此外,年龄≥65岁(OR=3.97,95%CI:1.68~9.38,P=0.002)、女性(OR=3.83,95%CI:1.64~8.93,P=0.002)、家属合并疾病数≥2个(OR=2.57,95%CI:1.03~6.41,P=0.043)也是家属焦虑的相关因素。结论症状较重的心房颤动患者合并焦虑的比例更高,且其家属焦虑可能性也更高。焦虑状态的心房颤动患者,其家属焦虑比例更高。

Objective To explore the risk factors of anxiety in patients with atrial fibrillation and their caregivers.Methods From September 2020 to March 2021,patients with atrial fibrillation and one primary family member as caregiver of each patient from Beijing Anzhen Hospital were enrolled.Basic data of patients and their caregivers were collected,and anxiety of patients and caregivers were evaluated by Generalized Anxiety Disorder‑7 scale(GAD‑7).A total of 374 patients with atrial fibrillation and their caregivers were included in this study.Multivariate logistic regression analysis was used to analyze the risk factors of anxiety of patients and their caregivers.Results The mean age of the patients was(58.3±10.6)years,and 124(33.2%)were female.The caregivers were(53.6±11.6)years old,and 247(66%)were female.69(18.4%)patients and 38(10.2%)caregivers had mild anxiety(GAD‑7:5‑9 scores),13(3.5%)patients and 9(2.4%)caregivers had moderate or higher anxiety(GAD‑7:10‑21 scores).Multivariate analysis showed that the risk factors of anxiety in patients with atrial fibrillation included EHRA score≥3(OR=1.73,95%CI:1.03-2.89,P=0.039)and female sex(OR=1.90,95%CI:1.06-3.40,P=0.032).EHRA score of patients≥3(OR=2.11,95%CI:1.05-4.24,P=0.036)or anxiety of patients(OR=2.76,95%CI:1.36-5.60,P=0.005)were associated with higher anxiety of caregivers.Moreover,age of≥65 years old(OR=3.97,95%CI:1.68-9.38,P=0.002),female sex(OR=3.83,95%CI:1.64-8.93,P=0.002)and number of comorbidities of caregivers≥2(OR=2.57,95%CI:1.03-6.41,P=0.043)were also associated with anxiety of caregivers.Conclusions Patients with severe symptoms have a higher proportion of anxiety,and their caregivers are more likely to experience anxiety.Anxiety rate is higher in caregivers of patients with anxiety.