Self-Reported Executive Function in Hospitalized Cardiac Patients and Associations With Patient Characteristics and Cardiac Rehabilitation Attendance.
Self-Reported Executive Function in Hospitalized Cardiac Patients and Associations With Patient Characteristics and Cardiac Rehabilitation Attendance.
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住院心脏病患者自我报告的执行功能以及与患者特征和心脏康复就诊的关联。
DOI：
10.1097/hcr.0000000000000785
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发表时间：
2023
影响因子：
3.8
通讯作者：
Gaalema,DiannE
中科院分区：
文献类型：
--
作者：
Katz,BrianR;Khadanga,Sherrie;Middleton,WilliamA;Mahoney,Katharine;Savage,PatrickD;DeSarno,Michael;Ades,PhilipA;Gaalema,DiannE
目的：执行功能(ExF)，即执行复杂认知任务的能力，如计划和克制冲动行为，与遵守医疗建议有关。本研究确定了自我报告的ExF与心脏病患者的人口学特征以及心脏康复(CR)就诊的相关性。方法：使用执行功能行为评定量表(Brief)对316名因符合CR标准的心脏事件住院的患者进行自我报告ExF损害的测量。计算了一项全球指标(全球高管综合指数[GEC])和两个简短指数：行为调节指数和元认知指数(MCI)的分数。参与者在出院后被跟踪，以确定CR出院情况。在ExF测量和人口统计变量之间进行了单变量Logistic回归，以及多个Logistic回归，以确定显著的独立预测因素。分析使用临床标准(T分数≥65)和亚临床标准(T分数≥60)作为结果。结果：自我报告的ExF缺陷相对较少；8.9%的患者至少有GEC的亚临床评分。使用MCI的亚临床标准，患有糖尿病(DM)和男性是MCI损害的显著独立预测因素。结论：仅采用亚临床标准，糖尿病患者和男性患者发生MCI损害的可能性显著增加。未发现ExF损伤对CR就诊率的显著影响，这表明在医院测量的自我报告的ExF可能不是预测行为结果的适当指标。
Purpose:Executive function (ExF), the ability to do complex cognitive tasks like planning and refraining from impulsive behavior, is associated with compliance with medical recommendations. The present study identified associations between self-reported ExF and demographics of patients with cardiac disease as well as with cardiac rehabilitation (CR) attendance.Methods:Self-reported ExF impairment was measured using the Behavior Rating Inventory of Executive Function (BRIEF) on 316 individuals hospitalized for CR-qualifying cardiac events. Scores were calculated for a global measure (Global Executive Composite [GEC]) and the two BRIEF indices: Behavioral Regulation Index and Metacognition Index (MCI). Participants were followed up post-discharge to determine CR attendance. Univariate logistic regressions between ExF measures and demographic variables were conducted, as were multiple logistic regressions to identify significant, independent predictors. Analyses were conducted using clinical (T scores≥ 65) and subclinical (T scores≥ 60) criteria for significant ExF impairment as outcomes. One-way analyses of variance were performed between ExF impairment and CR attendance.Results:Self-reported ExF deficits were relatively rare; 8.9% had at least subclinical scores on the GEC. Using the subclinical criterion for the MCI, having diabetes mellitus (DM) and being male were significant, independent predictors of MCI impairment. No significant relationship was found between ExF and CR attendance.Conclusion:Using the subclinical criterion only, individuals with DM and males were significantly more likely to have MCI impairment. No significant effect of ExF impairment on CR attendance was found, suggesting that self-reported ExF measured in the hospital may not be an appropriate measure for predicting behavioral outcomes.