Perceived control moderates the relationship between anxiety and in-hospital complications after ST segment elevation myocardial infarction.
Perceived control moderates the relationship between anxiety and in-hospital complications after ST segment elevation myocardial infarction.
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DOI：
10.2147/jmdh.s170326
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发表时间：
2018
影响因子：
3.3
通讯作者：
AbuRuz ME
中科院分区：
文献类型：
--
作者：
AbuRuz ME
焦虑是急性心肌梗死后常见的心理反应，可能与较高水平的住院并发症有关。感觉到的控制可能会缓和这种关系，但这种方法的效果在发展中国家还没有得到检验。因此，本研究的目的如下：1)检验焦虑是否是急性心肌梗死后院内并发症的独立预测因子；2)检验控制感是否调节了焦虑与急性心肌梗死后院内并发症之间的关系。这是一项前瞻性观察研究，从约旦安曼的三家私立医院招募了500名确诊为ST段抬高心肌梗死的患者。焦虑由医院焦虑和抑郁量表的焦虑子量表测量，控制感由阿拉伯语版本的控制态度量表修订而成。140名患者(28%)在住院期间至少出现一种并发症。255例患者焦虑评分低(≤7)，2 45例患者焦虑评分高(≥8)。控制感水平高的患者焦虑水平低于控制感低的患者(分别为5.3vs14.16.3，P<；0.001)。在Logistic回归分析中，在控制了社会人口学和临床变量后，焦虑是住院并发症的独立预测因素(优势比：1.24，95%CI，1.08-1.41，P<；0.01)。此外，焦虑和控制感的交互作用是并发症的重要预测因素。焦虑与急性心肌梗死后住院并发症的风险增加有关，与社会人口和临床变量无关。知觉控制感对这种联系有缓和作用，因为知觉控制感低和焦虑分数高的组合与并发症的风险最大相关。支持患者的知觉控制水平可以减少急性心肌梗死后的并发症、发病率和死亡率。
Anxiety is a common psychological response after acute myocardial infarction and might be associated with higher levels of in-hospital complications. Perceived control might moderate this relationship, but the effect of this method has not been checked in developing countries. Therefore, the objectives of this study were as follows: 1) to check if anxiety was an independent predictor of in-hospital complications after acute myocardial infarction; and 2) to check if perceived control moderates the relationship between anxiety and in-hospital complications after acute myocardial infarction. This was a prospective observational study among 500 patients with a confirmed diagnosis of ST segment elevation myocardial infarction recruited from three private hospitals in Amman, Jordan. Anxiety was measured by the Anxiety subscale of Hospital Anxiety and Depression Scale, and perceived control was measured by the Arabic version of the Control Attitude Scale-Revised. One hundred and forty patients (28%) developed at least one complication during hospitalization. Two hundred and fifty-five patients had low anxiety scores (≤7), and 245 patients had high anxiety scores (≥8). Patients with high levels of perceived control had lower levels of anxiety (mean [SD]; 5.3 [3.6] vs 14.1 [6.3], P<0.001) than those with low perceived control. In logistic regression, anxiety was an independent predictor of in-hospital complications after controlling for sociodemographic and clinical variables (odds ratio: 1.24, 95% CI, 1.08–1.41, P<0.01). Moreover, the interaction of anxiety and perceived control was a significant predictor of complications. Anxiety was associated with increased risk of in-hospital complications after acute myocardial infarction independent of sociodemographic and clinical variables. Perceived control had a moderating effect for this association since the combination of low perceived control and high anxiety scores was associated with the greatest risk for complications. Supporting patients’ levels of perceived control can decrease complications, morbidities, and mortality after acute myocardial infarction.