Anxiety Predicts Worse Cardiorespiratory Fitness Outcomes in Cardiac Rehabilitation for Lower Socioeconomic Status Patients.
Anxiety Predicts Worse Cardiorespiratory Fitness Outcomes in Cardiac Rehabilitation for Lower Socioeconomic Status Patients.
复制标题
焦虑预示着社会经济地位较低的患者在心脏康复中心肺健康结果会更差。
DOI：
10.1097/hcr.0000000000000852
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发表时间：
2024
影响因子：
3.8
通讯作者：
Gaalema,DiannE
中科院分区：
文献类型：
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作者：
Middleton,WilliamA;Savage,PatrickD;Khadanga,Sherrie;Rengo,JasonL;Ades,PhilipA;Gaalema,DiannE
目的：本研究的目的是表明心脏康复（CR）患者的低社会经济地位（SES）有更差的临床资料和更高的精神困难率，他们的心肺健康（CRF）改善比高社会经济地位（SES）的对应者更低。CR期间CRF的改善预示着更好的长期健康结果。研究表明，在有组织的锻炼方案中，较高的焦虑程度会损害CRF，并且在社会经济地位较低的患者中更为普遍。然而，没有研究确定这种关系是否适用于CR。方法：本研究是对一项随机对照试验的二次分析，该试验旨在提高低经济地位患者的CR出勤率。在CR入组前和4个月后收集焦虑（ASEBA ASR； Achenbach经验评估系统，成人自我报告）和CRF测量（代谢当量任务[METs峰值]）。在控制其他人口统计学和临床特征的同时，使用回归来检查焦虑与4个月时CRF的关系。结果：88名参与者被纳入分析，其中31%有临床显著的焦虑水平（T≥63）。当控制基线CRF、年龄、性别、合格诊断和参加CR会议次数时，高焦虑显著预测较低的退出CRF （β=−）。05, P =。04)。具有临床显著焦虑水平的患者有望在改善中失去>.65 METs峰值。结论：本研究的结果表明，焦虑在社会经济地位较低的人群中过度代表，在CR持续时间内与CRF改善程度较低相关。该效应量具有临床意义，需要进一步研究CR中的心理因素。
Purpose:The purpose of this study was to show that patients in cardiac rehabilitation (CR) with lower socioeconomic status (SES) have worse clinical profiles and higher rates of psychiatric difficulties and they have lower cardiorespiratory fitness (CRF) improvements from CR than their counterparts with higher SES. Improvement in CRF during CR predicts better long-term health outcomes. Research suggests that higher anxiety impairs CRF in structured exercise regimes and is overrepresented among patients with lower SES. However, no study has determined whether this relationship holds true in CR.Methods:This study is a secondary analysis of a randomized controlled trial to improve CR attendance among patients with lower SES. Anxiety (ASEBA ASR; Achenbach System of Empirically Based Assessment, Adult Self Report) and CRF measures (metabolic equivalent tasks [METs peak]) were collected prior to CR enrollment and 4 mo later. Regression was used to examine the association of anxiety with CRF at 4 mo while controlling for other demographic and clinical characteristics.Results:Eight-eight participants were included in the analyses, 31% of whom had clinically significant levels of anxiety (T≥ 63). Higher anxiety significantly predicted lower exit CRF when controlling for baseline CRF, age, sex, qualifying diagnosis, and number of CR sessions attended (β=−. 05, P=. 04). Patients with clinically significant levels of anxiety could be expected to lose> 0.65 METs peak in improvement.Conclusions:The results from this study suggest that anxiety, which is overrepresented in populations with lower SES, is associated with less CRF improvement across the duration of CR. The effect size was clinically meaningful and calls for future research on addressing psychological factor in CR.