倦怠对急性冠脉综合征患者康复过程中生活质量的影响研究

Influence of Burnout on the Quality of Life of Patients with Acute Coronary Syndrome

背景既往研究发现倦怠可导致急性冠脉综合征(ACS)患者在康复过程中体力恢复不良,但倦怠是否会导致ACS患者在中长期康复过程中的生活质量下降目前还不清楚。目的观察倦怠对ACS患者康复过程中生活质量的影响。方法选取2014年1月—2015年2月昆明医科大学第一附属医院心内科收治的ACS患者,收集其一般资料和临床资料。患者出院当天采用哥本哈根倦怠量表的一般倦怠子量表评估倦怠程度,将其分为高倦怠组和低倦怠组。并在出院当天、出院后1个月、半年和1年定期随访,采用生活质量8条简明量表(SF-8)和西雅图心绞痛量表(SAQ)评估患者生活质量,构建广义估计方程分析重复测量的生活质量指标在高倦怠组和低倦怠组中有无差别。结果共纳入91例患者,其中高倦怠组42例,低倦怠组49例。经校正性别、年龄、文化程度等混杂因素后,高倦怠组生理健康和心理健康得分均低于低倦怠组(Z=-3.21、-2.07,P<0.05);高倦怠组躯体受限程度(PL)、心绞痛稳定状态(AS)、心绞痛发作频率(AF)、治疗满意度(TS)、疾病认知程度(DP)得分均低于低倦怠组(Z=-5.23、-3.55、-3.76、-4.09、-4.92,P<0.05)。结论倦怠可导致ACS患者康复过程中生活质量下降。

Background Previous study have found that burnout can lead to poor physical recovery of patients withacute coronary syndrome （ACS） in the process of rehabilitation, but it is still not clear whether it will cause a decline in thequality of life of patients with ACS in the process of rehabilitation. Objective To observe the influence of burnout on the quality of life of patients with ACS in the process of rehabilitation. Methods The patients with first ACS in the Department of Cardiology, the First Affiliated Hospital of Kunming Medical University from January 2014 to February 2015 were selected, andtheir general information and clinical data were collected. On the day of discharge, patients were assigned into high burnout group and low burnout group according to their burnout degree by the General Burnout Subscale of Copenhagen Burnout Inventory- Regular follow - up was carried out on the day of discharge, and 1 month,half a year and a year after discharge. The quality of life of patients was assessed by 8 - item short - form generic health - related quality - of - life questionnaire （ SF-8 ） and Seattle Angina Questionnaire （ SAQ ）, and generalized estimation equations were constructed to analyze whether the repeatedmeasured quality of life in the high burnout group and low burnout group were different. Results Ninety - one subjects wereenrolled in this study, 42 in the high burnout group and 49 in the low burnout group. After adjustment of confounding factors such as gender, age and cultural degree, physical health score and mental health score of high burnout group were lower than those oflow burnout group （Z = - 3. 21, - 2 . 0 1 , P 〈0.05 ） ; the score of physical limited degree （ PL） , anginal stability （ AS）, attack frequency angina （ AF ）,treatment satisfaction （TS）, and degree of illness perceptions （ DP） in high burnout group was lower than those of low burnout group （Z = - 5. 23, - 3. 5 5,- 3. 7 6, - 4. 0 9, - 4. 9 2,P 〈 0. 0 5 ） . Conclusion will lead to a decline in the quality of life of patients with ACS during rehabilitation.