PCI术后冠心病病人心理弹性的纵向研究

Longitudinal study on psychological resilience in patients with coronary heart disease after PCI

目的:探讨经皮冠状动脉介入(PCI)术后冠心病病人心理弹性的变化趋势及影响因素。方法:采用一般资料调查表、10条目简易心理弹性量表、医学应对方式及正负性情绪量表对2021年10月—2022年10月在广西南宁市某三级甲等医院住院并行PCI术的180例冠心病病人进行纵向调查。结果:PCI术后冠心病病人在住院期间、术后1个月、术后3个月、术后6个月的10条目简易心理弹性得分依次为(23.77±4.61)分、(27.02±4.04)分、(26.60±3.65)分、(27.61±3.62)分。PCI术后冠心病病人心理弹性发展变化趋势受体质指数、饮酒史、病变冠状动脉数的影响(P<0.05);正性情绪、负性情绪、屈服应对对心理弹性变化趋势有影响;负性情绪对心理弹性的影响随时间变化而减弱;正性情绪、面对应对、回避应对、屈服应对对心理弹性的影响不随时间的变化而变化。结论:PCI术后冠心病病人术后6个月内的心理弹性趋势呈缓慢上升态势,体质指数、饮酒史、病变冠状动脉数影响其增长速率。正性情绪、负性情绪、屈服应对影响病人的心理弹性变化,其中正性情绪对心理弹性具有正向预测,负性情绪、屈服应对对其具有负向预测。负性情绪对心理弹性的影响会随着时间的延长而逐渐减弱。

Objective:To explore the change trend and influencing factors of psychological resilience in patients with coronary heart disease after PCI.Methods:A longitudinal survey was conducted on 180 patients with coronary heart disease who were hospitalized and underwent PCI in a tertiary hospital in Nanning,Guangxi from October 2021 to October 2022 by using the general data questionnaire,10⁃iterm Connor⁃Davidson Resilience Scale,The Positive and Negative Affect Scale and the Medical Coping Modes Questionnaire.Results:The psychological resilience scores of patients with coronary heart disease after PCI during hospitalization,1 month after operation,3 months after operation and 6 months after operation were 23.77±4.61,27.02±4.04,26.60±3.65 and 27.61±3.62,respectively.The development trend of psychological resilience was affected by BMI,drinking history and number of diseased coronary arteries(P<0.05).Positive emotions,negative emotions,and resignation coping had significant effects on the change trend of resilience.The effect of negative emotions on resilience decreased with time.The influence of positive affect,face coping,avoidance coping and yield coping on psychological resilience does not change with time.Conclusion:The psychological resilience of patients with coronary heart disease after PCI showed a slow upward trend within 6 months after operation.BMI index,drinking history and number of diseased coronary arteries affect the growth rate.Positive emotion,negative emotion and yield coping affect the change of resilience of patients.Positive emotion has a positive prediction on resilience,while negative emotion and yield coping have a negative prediction on resilience.The influence of negative emotions on psychological resilience will gradually decrease with time.