本文選題：急性冠脈綜合征 + 社會支持��； 參考：《重慶醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:調(diào)查急性冠狀動脈綜合征(acute coronary syndrome,ACS)患者的社會支持現(xiàn)況及相關(guān)影響因素,隨訪患者社會支持的一年變化,健康狀況的轉(zhuǎn)歸及心血管事件發(fā)生情況,分析社會支持對心血管預(yù)后的影響,為制定針對社會支持的治療策略提供依據(jù)。方法:2013年1月至2014年6月,于北京大學(xué)人民醫(yī)院、首都醫(yī)科大學(xué)附屬北京朝陽醫(yī)院、首都醫(yī)科大學(xué)附屬北京友誼醫(yī)院、北京中醫(yī)藥大學(xué)東直門醫(yī)院、北京市垂楊柳醫(yī)院心血管內(nèi)科篩選并納入符合標(biāo)準(zhǔn)的ACS住院患者778例,分別在入院7天內(nèi)、6月和12月完成調(diào)查問卷,包括ENRICHD社會支持評定量表(ENRICHD Social Support Inventory,ESSI)、廣泛性焦慮量表(general anxiety disorder scale,GAD-7)、患者健康問卷(patient health questionnaire,PHQ-9)、生活質(zhì)量量表(short-form 12 health survey questionnaire,SF-12)、睡眠問卷和社會人口信息學(xué)資料。隨訪一年,調(diào)查患者死亡、心絞痛復(fù)發(fā)、非致死性心肌梗死及再住院的情況。兩組均值的比較采用獨立樣本的t檢驗;多組均值的比較采用單因素方差分析,組間比較采用LSD法;計數(shù)資料的比較采用卡方檢驗;采用多元線性回歸方程分析ACS患者社會支持的相關(guān)影響因素。結(jié)果:本研究基線共收回有效問卷771例,其中男517例(67.1%),女254例(32.9%)。ACS患者基線、隨訪6月、12月的社會支持評分分別為17.08?3.61、17.72?3.04、17.76?3.05;與基線相比,6月(LSD-t=-2.69,P㩳0.01)和12個月(LSD-t=-2.86,P㩳0.01)的社會支持評分顯著增高,差異有統(tǒng)計學(xué)意義。社會支持基線多元線性回歸分析顯示,工人和農(nóng)民(t=2.82,P=0.01)、低家庭月收入(t=2.42,P=0.02)、焦慮(t=-3.66,P=0.00)、抑郁(t=-3.22,P=0.00)和低生活質(zhì)量(t=4.38,P=0.00)是低社會支持的獨立影響因素�？�?cè)巳旱囊荒晁劳雎屎头侵滤佬孕募」Ｋ缆屎艿?分別為0.4%和1.7%;且與社會支持水平無關(guān);而低社會支持者的心絞痛復(fù)發(fā)風(fēng)險(HR 1.66;95%CI1.06-2.62;P㩳0.05)和再住院風(fēng)險均顯著高于高社會支持者(HR2.16;95%CI1.16-4.05;P㩳0.05)。結(jié)論:在ACS患者中,工人和農(nóng)民、低家庭月收入者、伴有焦慮或抑郁者的社會支持偏低。反過來,低社會支持又與患者的焦慮抑郁狀態(tài)和低生活質(zhì)量和不良心血管預(yù)后密切相關(guān)。提示因采取針對社會支持的相關(guān)措施,從整體上改善急性冠脈綜合征患者的健康狀況和心血管預(yù)后。
[Abstract]:Objective: to investigate the social support status and related influencing factors in patients with acute coronary syndrome (ACS), to investigate the changes of social support, the outcome of health status and the occurrence of cardiovascular events in patients with acute coronary syndrome (ACS). To analyze the influence of social support on cardiovascular prognosis and to provide evidence for the formulation of treatment strategies for social support. Methods: from January 2013 to June 2014, Beijing Chaoyang Hospital, Capital Medical University, Beijing Friendship Hospital, Dongzhimen Hospital, Beijing University of traditional Chinese Medicine, Beijing University of traditional Chinese Medicine, Beijing Medical University, Beijing Medical University, Beijing Hospital of Friendship, Beijing University of traditional Chinese Medicine, 778 ACS inpatients who met the criteria were selected and included in the Department of Cardiovascular Medicine of Beijing Tuiyangliu Hospital. The questionnaires were completed within 7 days of admission and in June and December, respectively. It includes the ENRICHD Social support rating scale (ENRICHD Social Support inventory), the generalized anxiety disorder scale (anxiety disorder scale), the patient health questionnaire (PHQ-9), the quality of Life scale (short form 12 health survey questionnaire) SF-12, the sleep questionnaire and the social-demographic informatics data. Follow up for one year to investigate death, recurrence of angina pectoris, non-fatal myocardial infarction and re-hospitalization. T test of independent samples was used to compare the mean values of two groups, single factor analysis of variance was used to compare multiple mean values, LSD method was used in comparison between groups, chi-square test was used to compare counting data. Multivariate linear regression equation was used to analyze the related factors of social support in patients with ACS. Results: a total of 771 effective questionnaires were collected from the baseline in this study, including 517 males (67.1%) and 254 females (32.9%), followed up for 6 months. The scores of social support for 12 months were 17.083.61and 17.723.04 and 17.763.05, respectively. Compared with the baseline, the scores of social support in June (LSD-t-2.69P0. 01) and 12 months (LSD-t- 2.86P0. 0. 0) were significantly higher than those in baseline. The difference is statistically significant. The multivariate linear regression analysis of social support baseline showed that workers and peasants were independent factors of low social support, such as 2.82% P0. 01, 2. 42% P0. 02 of low household income, 3. 66% P0. 00m of anxiety, 3. 22% P0. 00 of depression, and 4. 38 P0. 00. of low quality of life. The annual mortality rate and non-fatal myocardial infarction rate of the total population were very low (0.4% and 1.7%, respectively), and were not related to the level of social support, while the risk of angina pectoris recurrence in the low social supporters was 1.6695% (CI 1.06-2.62P0. 05) and the risk of rehospitalization was significantly higher than that of the high social supporters (HR2.1695CI1.16-4.05 P0.05G). Conclusion: in ACS patients, workers and farmers, low family monthly income, anxiety or depression with low social support. In turn, low social support is associated with anxiety and depression, low quality of life and poor cardiovascular outcomes. It is suggested that the health status and cardiovascular prognosis of patients with acute coronary syndrome can be improved by taking relevant measures aimed at social support.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R541.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 王歷;陸凱;李建超;勝利;丁榮晶;胡大一;;患者健康問卷在心血管門診抑郁障礙篩查中的價值[J];中華心血管病雜志;2015年05期

2 王歷;陸凱;王長鷹;勝利;胡大一;丁榮晶;;GAD-2和GAD-7在心血管門診焦慮篩查中的信度與效度分析[J];四川精神衛(wèi)生;2014年03期

3 張二箭;田福利;張賓;;心血管疾病患者焦慮抑郁癥狀調(diào)查研究[J];中國循證心血管醫(yī)學(xué)雜志;2013年04期

4 劉莉;王玉環(huán);吳勇娟;;冠脈搭橋術(shù)后住院病人社會支持及影響因素分析[J];全科護(hù)理;2012年36期

5 裴大軍;陳芳;石宏偉;梁錦軍;;心血管疾病患者社會支持與生活質(zhì)量關(guān)系的研究[J];醫(yī)學(xué)研究雜志;2011年10期

6 石宏偉;陳芳;裴大軍;梁錦軍;;不同人口學(xué)特征心血管疾病患者社會支持特點研究[J];護(hù)理學(xué)報;2011年14期

7 ;急性ST段抬高型心肌梗死診斷和治療指南[J];中華心血管病雜志;2010年08期

8 岳文芳;馮社芬;趙義琴;張衛(wèi)紅;;社會支持對老年冠心病患者心理狀況及生活質(zhì)量的影響[J];中國綜合臨床;2009年01期

9 馬文林;李美婧;張俊蒙;劉光輝;李覺;胡大一;;急性冠脈綜合征后焦慮抑郁時點現(xiàn)患率調(diào)查[J];中國心理衛(wèi)生雜志;2008年05期

10 劉慶武;肖水源;周少平;周勇;李軍;;社會支持、焦慮和抑郁情緒對中小學(xué)教師生活質(zhì)量影響的路徑分析[J];中華行為醫(yī)學(xué)與腦科學(xué)雜志;2009年01期

，

本文編號：1826599