D型人格和应对方式对急性心肌梗死患者就医决策延迟的影响

The effect of type D personality and coping style on the delay of medical treatment decision-making in the patients with acute myocardial infarction

目的 了解急性心肌梗死(AMI)患者的就医决策延迟现状,并探讨D型人格和应对方式与就医决策延迟之间的关系。方法 采用一般资料调查表、D型人格量表(DS-14)及医学应对问卷(MCMQ)对232例AMI患者进行调查,并随机抽取患者调查问卷与病历,以保证收集时间的一致性。结果 232例患者就医决策延迟时间的中位数为128 min,共133例患者发生延迟,发生率为57.3%。DS-14总分及各维度应对方式中回避应对与就医决策延迟时间呈正相关(均P<0.01),面对应对与就医决策延迟时间呈负相关(P<0.05)。回避应对在D型人格与就医决策延迟时间关系中起部分中介作用,中介效应占总效应的34.5%。结论 D型人格和应对方式与AMI患者的就医决策延迟有关,医护人员应重视D型人格对就医决策时间的影响,重点关注AMI高危人群,早期筛查与识别,以便尽早采取针对性干预措施,促进其积极应对,最终缩短就医决策延迟时间。

Objective To understand the current situation of delayed medical decision in patients with acute myocardial infarction(AMI), and to explore the relationship of type D personality and coping style with delayed medical decision. Methods A total of 232 patients with AMI were investigated with the General Information Questionnaire, D-type Personality Inventory(DS-14) and Medical Coping Modes Questionnaire(MCMQ), and the questionnaires and medical records were randomly selected to ensure the consistency of collection time. Results The median delay time of medical decision in 232 patients was 128 min, and 133 patients were delayed with an incidence of 57.3%. The total score of DS-14 and the avoidance coping in coping style were positively correlated with the delay time of medical decision(all P<0.01), while face coping was negatively correlated with the delay time of medical decision(P<0.05). Avoidance coping played a partial mediating role in the relationship of the type D personality with the delay time of medical decision, and the mediating effect accounted for 34.5% of the total effect. Conclusions Type D personality and coping style are related to the delay of medical decision-making in the patients with AMI. Medical staff should pay attention to the influence of type D personality on the time of medical decision-making, focus on the high-risk groups of AMI, early screening and identification, so as to take targeted intervention measures as soon as possible, promote their active response, and finally shorten the delay time of medical decision-making.