Characteristics of socially isolated patients with coronary artery disease who are at elevated risk for mortality
Characteristics of socially isolated patients with coronary artery disease who are at elevated risk for mortality
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DOI：
10.1097/00006842-200103000-00010
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发表时间：
2001-03-01
影响因子：
3.3
通讯作者：
Mark, DB
中科院分区：
文献类型：
--
作者：
Brummett, BH;Barefoot, JC;Mark, DB
目的：社会隔离与冠状动脉疾病（CAD）患者的低生存率有关。很少有研究仔细检查缺乏社会接触的CAD患者的心理社会特征。方法：对430例冠心病患者进行社会隔离作为死亡率预测因子的研究。在可能有助于解释隔离与生存之间关系的因素上，将隔离程度较高的患者与隔离程度较低的患者进行比较。结果：孤立个体死亡率较高。在控制年龄和疾病严重程度的情况下，社会支持网络中有三个或更少的人的心脏死亡率相对风险为2.43 (p = 0.001)，全因死亡率相对风险为2.11 （p = 0.001）。对收入、敌意和吸烟状况的调整并没有改变由于社会孤立造成的风险。除了收入较低、敌意评级较高和吸烟率较高外，隔离患者在人口统计指标、疾病严重程度、身体功能或心理困扰方面与非隔离患者没有差异。被隔离的患者报告的社会支持较少，对他们与网络成员相处的方式也不太满意，但他们对获得的社会接触数量的满意度并没有降低。结论：社交网络较小的患者死亡风险较高，但这种较高的风险与疾病严重程度、人口统计学或心理困扰无关。这些发现对将社会孤立与死亡率联系起来的机制以及社会心理干预措施的应用具有影响。
Objectives: Social isolation has been linked to poor survival in patients with coronary artery disease (CAD]. Few studies have closely examined the psychosocial characteristics of CAD patients who lack social contact. Methods: Social isolation was examined as a predictor of mortality in 430 patients with significant CAD. More isolated patients were compared with their less isolated counterparts on factors that might help explain the association between isolation and survival. Results: The mortality rate was higher among isolated individuals. Those with three or fewer people in their social support network had a relative risk of 2.43 (p =.001) for cardiac mortality and 2.11 (p =.001) for all-cause mortality, controlling for age and disease severity. Adjustments for income, hostility, and smoking status did not alter the risk due to social isolation. With the exception of lower income, higher hostility ratings, and higher smoking rates, isolated patients did not differ from nonisolated patients on demographic indicators, disease severity, physical functioning, or psychological distress. Isolated patients reported less social support and were less pleased with the way they got along with network members, but they did not report less satisfaction with the amount of social contact received. Conclusions: Patients with small social networks had an elevated risk of mortality, but this greater risk was not attributable to confounding with disease severity, demographics, or psychological distress. These findings have implications for mechanisms linking social isolation to mortality and for the application of psychosocial interventions.