Coping with posttraumatic stress disorder and comorbidity after myocardial infarction
Coping with posttraumatic stress disorder and comorbidity after myocardial infarction
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DOI：
10.1016/j.comppsych.2007.08.003
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发表时间：
2008-01-01
影响因子：
7.3
通讯作者：
Rudd, Hannah
中科院分区：
文献类型：
--
作者：
Chung, Man Cheung;Berger, Zoee;Rudd, Hannah
目的：关于应对策略、心肌梗死后创伤后应激(后MI PTSD)和共病之间关系的文献有限。本研究旨在通过探讨两者之间的关系来填补文献中的空白。方法：120名MI患者来自2个全科诊所，采用创伤后应激诊断量表、一般健康问卷和应对方式量表进行访谈。结果：31%的患者患有创伤后应激障碍。患者使用以接受为中心的应对方式，因为他们中的大多数人接受MI已经发生，并且它不能改变。与此同时，一些患者使用了回避为重点的应对方式，因为他们在精神和行为上脱离了MI的创伤影响。当年龄、搭桥手术、零度手术前的心理健康问题和血管成形术前的心理健康问题保持不变时，结果表明，使用以情绪为重点和以回避为重点的适应不良应对策略的患者倾向于报告更多的共病症状。接受过搭桥手术和血管成形术等医疗程序或干预措施的患者倾向于报告更多的创伤后应激障碍症状。结论：MI患者的应对策略与健康结局的关系已显示出症状特有的方式。使用适应不良的应对策略并不一定会对创伤后应激障碍症状产生重大影响。另一方面，治疗心肌梗死的医疗程序或干预措施在维持心肌梗死患者的创伤后应激障碍症状方面发挥着重要作用。(C)2008 Elsevier Inc.保留所有权利。
Objective: Literature on the relationship between coping strategies, posttraumatic stress after myocardial infarction (post-MI PTSD), and comorbidity is limited. This study aimed to fill this gap in literature by investigating this relationship.Method: One hundred twenty patients with MI were recruited from 2 general practices and interviewed using the Posttraumatic Stress Diagnostic Scale, the General Health Questionnaire, and the COPE Scale.Results: Thirty-one percent had PTSD. Patients used acceptance-focused coping in that most of them accepted that the MI had happened and that it could not be changed. At the same time, some patients used avoidance-focused coping in that they disengaged themselves mentally and behaviorally from the traumatic effects of MI. When the variables of age, bypass surgery, mental health problems before NIL and angioplasty were held constant, the results showed that patients who used maladaptive coping strategies of emotion-focused and avoidance-focused copings tended to report more comorbid symptoms. Patients who underwent medical procedures or interventions such as bypass surgery and angioplasty tended to report more PTSD symptoms.Conclusions: The way in which MI patients' coping strategies relate to health outcomes has been shown to be symptom-specific. Using maladaptive coping strategies does not necessarily have a significant impact on PTSD symptoms. On the other hand, medical procedures or interventions for treating MI can play a major role in maintaining PTSD symptoms for patients with MI. (c) 2008 Elsevier Inc. All rights reserved.