Illness Perceptions, Coping Strategies, and Symptoms Contribute to Psychological Distress in Patients With Recurrent Symptomatic Atrial Fibrillation
Illness Perceptions, Coping Strategies, and Symptoms Contribute to Psychological Distress in Patients With Recurrent Symptomatic Atrial Fibrillation
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DOI：
10.1097/jcn.0b013e31821e7ab1
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发表时间：
2012-09-01
影响因子：
2
通讯作者：
Barnason, Susan A.
中科院分区：
文献类型：
--
作者：
McCabe, Pamela J.;Barnason, Susan A.
背景：心房颤动（AF）是一种与心理困扰相关的普遍、危及生命的疾病。需要干预措施来管理AF患者的心理挑战。有证据表明，疾病观念、应对策略和导致心理困扰的症状可以通过心理教育干预来改变，以减少心理困扰。然而，对于疾病认知、应对策略和症状如何导致房颤患者的心理困扰，我们知之甚少。在Levethal自我调节常识模型的指导下，这项相关研究的目的是确定疾病认知、应对策略、症状频率和症状严重程度对复发性症状性房颤患者心理困扰的影响程度。这些因素的影响考虑了性别、年龄、房颤类型和房颤诊断后时间的影响。方法：参与者（n = 207，男性占56%，年龄64.2 +/- 12.3岁）完成疾病知觉问卷-修订、COPE量表、症状表-频率和严重程度、情绪状态概况。数据分析采用Pearson相关和层次多元回归。结果：疾病认知对心理困扰的影响最大，其次是应对策略和症状频率。疾病感知解释了以下总方差的最大部分：紧张焦虑，44/56%；Depression-Dejection 38/50%;Fatigue-Inertia 43/53%;Confusion-Bewilderment 41/49%;Vigor-Activity 24/35%;和总情绪障碍，47/63%。对房颤有严重后果的疾病认知、心理原因和对房颤的理解不足共同导致了全面情绪障碍（0.47），而不是关注情绪（0.08）或症状频率（0.06）。结论：疾病认知是房颤患者发生心理困扰的重要因素，通过对患者疾病认知的评估，可以发现增加房颤患者发生心理困扰风险的因素。研究有必要评估干预措施，以改变心理上的因果信念，促进对房颤的理解。
Background: Atrial fibrillation (AF) is a prevalent, life-complicating illness associated with psychological distress. Interventions to manage the psychological challenges of living with AF are needed. Evidence suggests that illness perceptions, coping strategies, and symptoms that contribute to psychological distress may be modified by psychoeducational interventions to reduce psychological distress. However, little is known about how illness perceptions, coping strategies, and symptoms contribute to psychological distress in patients with AF. Objective: The aim of this correlational study guided by Levethal's Common Sense Model of Self-regulation was to identify the extent to which illness perceptions, coping strategies, symptom frequency, and symptom severity contributed to psychological distress in patients with recurrent symptomatic AF. The contribution of these factors was considered with respect to the effects of gender, age, type of AF, and time since AF diagnosis. Methods: Participants (n = 207; 56% male; 64.2 +/- 12.3 years old) completed the Illness Perception Questionnaire-Revised, the COPE Inventory, the Symptom Checklist-Frequency and Severity, and the Profile of Mood States. Data were analyzed using Pearson correlation and hierarchical multiple regression. Results: Illness perceptions contributed most to psychological distress, followed by coping strategies and symptom frequency. Illness perceptions explained the largest portion of the total variance for the following: Tension-Anxiety, 44/56%; Depression-Dejection, 38/50%; Fatigue-Inertia, 43/53%; Confusion-Bewilderment, 41/49%; Vigor-Activity, 24/35%; and Total Mood Disturbance, 47/63%. Illness perceptions of AF as having serious consequences, a psychological cause, and perceived poor understanding of AF together contributed more (.47) to Total Mood Disturbance than did coping by focusing on emotion (.08) or symptom frequency (.06). Conclusions: Illness perceptions are important contributors to psychological distress in patients with AF. Assessment of patients' illness perceptions may reveal those that increase the risk for psychological distress. Research is warranted to evaluate interventions to modify psychological cause and consequence beliefs and to promote understanding of AF.