冠心病患者自责归因行为的潜在类别分析与感知控制的关系研究

Relationship between potential category analysis and perceived control of self blame attribution behavior in patients with coronary heart disease

目的探索冠心病患者自责归因行为的潜在类别,并探讨各类别在一般人口学资料和病理学资料的分布差异,分析各类别与应对方式的关系。方法采用自制的一般资料调查表、中文版心脏病自责归因量表(cardiac self-blame attributions scale,CSBAS),修订版控制态度量表(conrtol attitudes scale-revised,CAS-R)对2021年8月-2022年8月在我院就诊的213例冠心病患者进行调查。运用潜在剖面分析方法探讨自责归因行为的潜在类别。结果冠心病患者的自责归因行为可分为高性格自责组(16.4%)、低自责归因组(34.84%)和高行为自责组(48.8%)3个类别。多因素分析结果显示,年龄更小、初中文化水平的更可能进入“低自责归因组”,吸烟、直系亲属有冠心病家族史更可能进入“高性格自责组”;年龄更小更可能进入“低自责归因组”,高中或中专文化程度、冠心病病程较长、连续戒烟≥6个月、直系亲属有冠心病家族史、运动频次>3次/周更可能进入“高行为自责组”;直系亲属有冠心病家族史更可能进入“高行为自责组”(P<0.05)。冠心病自责归因3个类别在感知控制及各维度得分差异有统计学意义(P<0.05),其中高行为自责组患者的感知控制得分最高,其次是高性格自责组,最低是地自责行为组(P<0.05)。结论冠心病患者的自责归因有明显的分类特征,且每个类别患者的感知控制不同,医护人员应根据患者自责归因分类特点以及各项影响因素对不同类别患者的影响采取个性化的心理疏导及信息支持等干预措施,以提高冠心病患者的心理健康水平。

Objective To explore the potential categories of self blame attribution behavior in patients with coronary heart disease,and discuss the distribution differences of each category in general demography data and pathological data,and analyze the relationship between each category and coping style.Methods A self-made general information questionnaire,cardiac self-blame attributions scale(CSBAS),and conrtol attitudes scale-revised(CAS-R)were used to investigate 213 patients with coronary heart disease who visited our hospital from August 2021 to August 2022.The potential categories of self blame attribution behavior was explored by using the potential profile analysis method.Results The self blame attribution behavior of coronary heart disease patients was divided into 3 categories:high self blame personality attribution group(16.4%),low self blame behavior attribution group(34.84%),and high self blame behavior attribution group(48.8%).The results of multiple factors analysis showed that junior middle school culture level was more likely to enter the"low self blame behavior attribution group",smoking,immediate family members with a family history of coronary heart disease were more likely to enter the"high self blame personality attribution group";Younger age was more likely to be in the"low self blame behavior attribution group",and education level of senior high school or technical secondary school,longer course of coronary heart disease,continuous smoking cessation≥6 months,immediate family history with a family history of coronary heart disease,and exercise frequency>3/week were more likely to be in the"high self blame behavior attribution group";Immediate relatives had a family history of coronary heart disease were more likely to enter the"high self blame behavior attribution group"(P<0.05).There were differences in perceived control and scores in various dimensions among 3 categories of coronary heart disease self blame attribution(P<0.05),with patients in the high self blame behavior attribution group having the highest perceived control score,followed by the high self blame personality attribution group,and the lowest being the local self blame behavior group(P<0.05).Conclusion The attribution of self blame in patients with coronary heart disease has obvious classification characteristics,and the perceived control of each category of patients is different.Medical staff should take personalized psychological counseling and information support interventions based on the classification characteristics of patient attribution of self blame and the impact of various influencing factors on different categories of patients,in order to improve the mental health level of coronary heart disease patients.