不同治疗方案对持续性快室率心房颤动患者疾病感知和医学应对方式的影响

Effect of different treatment protocols in illness perception and medical coping modes of patients with rapid ventricular rate of persistent atrial fibrillation

目的分析不同治疗方案对持续性快室率心房颤动(以下简称“房颤”)患者疾病感知和医学应对方式的影响。方法选取2017年9月—2019年9月武汉大学人民医院心内科收治的持续性快室率房颤患者共129例,采用疾病感知问卷简化版(BIPQ)及医学应对方式问卷(MCMQ)进行调查研究,共回收得到127例患者的问卷,将其按不同治疗方式分为手术组(射频消融术,58例)和药物组(69例)。比较两组问卷结果及各维度得分的相关性。结果手术组认知表征得分、疾病感知总得分、面对维度得分均高于药物组,情绪表征、回避维度、屈服维度得分均低于药物组,差异均有统计学意义(均P<0.05)。两组疾病理解能力得分比较,差异无统计学意义(P>0.05)。两组认知表征、疾病理解力得分与面对维度得分均呈正相关(r>0,P<0.01),与回避、屈服维度得分均呈负相关(r<0,P<0.05)。两组情绪表征得分与屈服维度得分呈正相关(r>0,P<0.05)。手术组情绪表征得分与回避维度得分呈正相关(r>0,P<0.05),与面对维度得分呈负相关(r<0,P<0.05)。结论经手术治疗的持续性快室率房颤患者,对自身疾病的认识更为严重,且更倾向于采取面对的应对方式。经药物治疗的患者,情绪更易受疾病影响,且更倾向于采取回避、屈服的应对方式。

Objective To analyze the effects of different treatment protocols in illness perception and medical coping modes of patients with rapid ventricular rate of persistent atrial fibrillation.Methods A total of 129 patients with rapid ventricular rate of persistent atrial fibrillation admitted to Renmin Hospital of Wuhan University from September 2017 to September 2019 were recruited.The brief illness perception questionnaire(BIPQ)and the medical coping modes questionnaire(MCMQ)were used to conduct the investigation.A total of 127 patients were collected.According to different treatment methods,they were divided into operation group(radiofrequency ablation,58 cases)and drug group(69 cases).The results of the questionnaires in two groups were compared,as well as the correlation between the scores of each dimension.Results The scores of cognitive representation,total score of illness perception and face dimension in the operation group were higher than those in the drug group,while the scores of emotional representation,avoidance dimension and yield dimension were lower than those in the drug group,with statistical significance(all P<0.05).There was no significant difference in illness comprehension scores between the two groups(P>0.05).The scores of cognitive representation and understanding of illness were positively correlated with the scores of face dimension(r>0,P<0.01),and negatively correlated with the scores of avoidance and yield dimension(r<0,P<0.05).There was a positive correlation between the score of emotional representation and the score of yield dimension in the two groups(r>0,P<0.05).In the operation group,the emotional representation score was positively correlated with the avoidance dimension score(r>0,P<0.05),and negatively correlated with the face dimension score(r<0,P<0.05).Conclusion Patients with rapid ventricular rate of persistent atrial fibrillation who are treated with operation have a more severe awareness of their illness and are more likely to adopt a face to face approach. Patients who are treaded with medication are more emotionally affected by the illness and are more likely to adopt avoidance and submission coping styles.