D型人格及相关社会心理因素对慢性心衰患者生活质量的影响

Effects of type D personality and related psychosocial factors on quality of life in patients with chronic heart failure

目的 探讨D型人格与焦虑、抑郁、社会支持水平等相关社会心理因素对慢性心衰（chronic heart failure,CHF）患者生活质量的影响.方法 选择住院的CHF患者150例.依据D型人格量表（DS14）把所有CHF患者分为D型人格组和非D型人格组,两组均在接受治疗前进行一般状况调查表、明尼苏达心力衰竭生活质量量表（MLHFQ）、焦虑自评量表（SAS）、抑郁自评量表（SDS）和社会支持评定量表（SSRS）的测试.结果 （1）D型人格组的焦虑得分、抑郁得分[分别为（52.16±8.86）分、（56.82±10.29）分]均明显高于非D型人格组[分别为（43.56±7.33）分、（46.59±10.07）分]（P＜0.01）;D型人格组的社会支持得分[（34.00±7.18）分]明显低于非D型人格组[（41.57±7.61）分]（P＜0.01）;D型人格、消极情感、社交压抑均与焦虑（r=0.452、0.521、0.230）、抑郁（r=0.458、0.477、0.296）呈正相关,与社会支持水平（r=-0.336、-0.271、-0.316）呈负相关（P＜0.01）.（2）在生活质量方面,D型人格组的得分[（58.61±17.12）分]明显高于非D型人格组[（36.67±17.63）分]（P＜0.01）.（3）在生活质量影响因素的多元逐步回归分析中,D型人格、焦虑、抑郁、社会支持水平和NYHA分级进入回归方程（β值分别为-9.074、0.418、0.512、-0.519、6.58,P＜0.05）.结论 D型人格与CHF患者焦虑、抑郁、社会支持水平具有相关性,D型人格及焦虑、抑郁、社会支持水平等相关社会心理因素影响CHF患者的生活质量.

Objective To explore the effects of type D personality and related psychosocial factors on quality of life in patients with chronic heart failure （CHF）.Methods According to the type D personality scale （DS14）,150 patients with CHF were divided into the type D personality group and the non-type D personality group.All patients were investigated with the general healthy questionnaire,minnesota living with heart failure questionnaire（MLHFQ）,Zung＇ s self-rating anxiety scale（SAS）,Zung＇ s self-rating depression scale（SDS） and Social support rating scale （SSRS） before receiving treatment.Results （1）The scores of SAS,SDS in the type D personality group were higher than those in the non-type D personality group（52.16±8.86 vs 43.56±7.33,56.82± 10.29 vs 46.59± 10.07,separately） （P〈0.01）.The score of SSRS in the type D personality group was lower than that in the non-type D personality group（34.00±7.18 vs 41.57±7.61,P〈0.01）.The type D personality,negative affectivity （NA） and social inhibition （SI） were positively correlated with anxiety and depression （r=0.452,0.521,0.230;0.458,0.477,0.296,separately） （P〈0.01）,and the type D personality,NA and SI were negatively correlated with social support level（r=-0.336,-0.271,0.316,P〈0.01）.（2）The score of MLHFQ in the type D personality group was significantly higher than that in the non-type D personality group （58.61 ± 17.12 vs 36.67± 17.63,P〈 0.01）.（3）Multiple stepwise regression analysis showed that type D personality,anxiety,depression,social support level and NYHA class entered the quality of life regression equation（β=-9.074,0.418,0.512,-0.519,6.584,P〈 0.05）.Conclusion The type D personality of CHF is closely related to anxiety,depression and social support level,and type D personality and related psychosocialfactors affect the quality of life of CHF.