疾病不确定感对急性心肌梗死患者2周康复程序疗效的影响(英文)

Influence of sensation of uncertainty in illness on curative effect of two-weekrehabilitation program in patients with acute myocardial infarction

目的:观察疾病不确定感对急性心肌梗死(AMI)患者2周康复程序疗效的影响。方法:连续选择近期在我院救治的AMI患者85例,接受2周康复程序治疗和"Missals疾病不确定感量表"评估,并根据评分结果分为中-高分组(74.8～117.4分,51例)和低分组(32～74.7分,34例),并与同期就诊的43例冠心病心绞痛患者(CHD对照组)比较。结果:AMI患者不确定感量表各维度分及总分[总分(78.34±15.20)分比(60.61±12.42)分]均明显高于CHD对照组(P<0.05～0.01)。AMI患者不确定感中-高分组的运动峰值心率明显大于低分组[(137.80±26.49)次/min比(126.12±20.51)次/min,P<0.01]。与低分组比较,中、高分组的ADL总分[(84.15±16.38)分比(73.92±14.21)分]、SF-36总分[(45.22±6.86)分比(37.95±6.43)分]均明显减少,而SCL-90总分[(138.35±36.47)分比(151.87±42.61)分]、平均CCU天数[(2.53±0.26)d比(2.77±0.29)d]、平均卧床天数[(4.46±0.25)d比(5.38±1.22)d]、平均住院天数[(20.48±3.16)d比(25.37±3.82)d]和平均住院费[(3.91±0.82)万元比(4.57±0.93)万元]均明显增加(P<0.05～0.01)。结论:急性心肌梗死患者存在着明显的疾病不确定感,使2周康复程序的疗效显著下降。

Objective： To observe influence of sensation of uncertainty in illness on curative effect of two--week re-habilitation program in patients with acute myocardial infarction （AMI）. Methods： A total of 85 AMI patients recently treated in our hospital were selected continuously. They received two--week rehabilitation program treatment and were assessed by Missals uncertainty in illness scale （MUIS）. According to MUIS scores, AMI patients were di- vided into middle--high score group （74.8--117.4 scores, n=51） and low score group （32~74.7 scores, n=34）, and they were compared with 43 patients with coronary heart disease （CHD） angina pectoris （CHD control group） received treatment in the same period. Results.. Compared with CHD control group, there were significant increase in each dimension score and total score of MUIS [total score （60.61±12.42） scores vs. （78. 34±15.20） scores] in AMI patients （P〈0.05-0.01）. The exercise peak heart rate of MUIS middle--high score group was significantly higher than that of low score group [ （137.80±26.49） times/rain vs. （126.12±20.51） times/rain, P〈0. 01]. Compared with low score group, there were significant decrease in total scores of activity of daily living （ADL） scale [ （84. 15±16.38） scores vs. （73.92±14.21） scores] and the 36--item short-form general heath survey [SF-36,（45.22±6.86） scores vs. （37. 95±6.43） scores], and significant increase in total score of symptom checklist （SCL） -90[（138.35±36.47） scores vs. （151.87±42.61） scores], mean days in CCU[（2. 53±0. 26） dvs. （2. 77±0.29） d], mean days on bed [ （4. 46±0.25） d vs. （5.38±1.22） d], mean hospital day [ （20. 48±3.16） d vs. （25. 37±3.82） d] and mean inpatient fee [-（39.1±8.2） thousand RMB vs. （45.7±9.3） thousand RMB] in middle--high score group, P〈0.05-d0.01. Conclusion： There is significant sensation of uncertainty in illness in patients with acute myocardial infarction, and it makes curative effect of two--week rehabilitation program significantly decrease.