心肌梗死PCI术后患者心理社会适应现状及影响因素研究-现代医学

心肌梗死PCI术后患者心理社会适应现状及影响因素研究

单位：1. 首都医科大学附属北京朝阳医院心脏中心, 北京 100020;
2. 首都医科大学附属北京朝阳医院导管室, 北京 100020

分类号：R542.2

出版年·卷·期（页码）：2026·54·第一期（42-49）

摘要：

目的：探究心肌梗死经皮冠状动脉介入术(PCI)术后患者心理社会适应现状及其影响因素。方法：于2022年12月至2024年12月，对本院门诊收治的182例心肌梗死PCI术后患者的临床资料实施回顾性分析。调查患者的心理社会适应量表(PAIS-SR)、简易应对方式问卷(SCSQ)、疾病感知问卷(B-IPQ)、家庭关怀度指数问卷(APGAR)评分情况，应用Pearson或Sperman相关分析PAIS-SR评分与各量表得分相关性，采用多重线性回归模型分析心肌梗死PCI术后患者PAIS-SR评分的影响因素。结果：182例研究对象PAIS-SR评分平均(42.50±13.68)分。相关分析显示，PAIS-SR评分与积极应对、APGAR评分均呈负相关(r=-0.980、-0.926，P<0.05)，与消极应对、B-IPQ评分均呈正相关(r=0.930、0.925，P<0.05)。线性回归模型结果显示，首发心梗、每周运动3~5次、每周运动>5次、积极应对评分、消极应对评分、B-IPQ评分、APGAR评分均是心肌梗死PCI术后患者心理社会适应水平的影响因素(P<0.05)，进一步分层线性回归显示，模型1解释因变量变异的51.9%(R²=0.519,P<0.001)，模型2解释率显著提升(ΔR²=0.464，P<0.01)，模型2的R值和R²明显大于模型1，表明加入积极应对、消极应对、B-IPQ、APGAR评分后回归模型更优。结论：心肌梗死PCI术后患者部分存在心理社会适应障碍，其水平受首发心梗、运动情况、疾病感知、应对方式及家庭功能等影响。临床实践应超越单纯生物医学模式，构建整合认知重构、应对技能训练与家庭支持的综合干预策略。

Objective: To explore the psychosocial adaptation status and its influencing factors in patients with myocardial infarction after percutaneous coronary intervention(PCI). Methods: A retrospective analysis was conducted from December 2022 to December 2024 on the clinical data of 182 patients diagnosed with myocardial infarction who underwent PCI at our hospital's outpatient department. The study involved the evaluation of the Self-Report Psychosocial Adjustment to Illness Scale(PAIS-SR), Simplified Coping Style Questionnaire(SCSQ), Brief Illness Perception Questionnaire(B-IPQ), and the Family APGAR Index(APGAR). Pearson and Spearman correlation analysis was employed to examine the relationships between the PAIS-SR scores and the scores of each assessment scale. Multiple linear regression model was adopted to identify the influencing factors of PAIS-SR scores in patients after PCI for myocardial infarction. Results: The mean PAIS-SR score among the 182 participants was 42.50±13.68. Correlation analysis revealed a significant negative correlation between PAIS-SR score and positive coping, APGAR score(r =-0.980, -0.926, P<0.05), whereas a significant positive correlation was observed in negative coping, B-IPQ score(r=0.930, 0.925, P<0.05). The linear regression model showed that the first myocardial infarction, weekly exercise 3-5 times, weekly exercise>5 times, positive coping, negative coping, B-IPQ score, and APGAR score were all factors affecting the psychosocial adaptation level of patients with myocardial infarction after PCI(P<0.05). Further stratified linear regression analysis indicated that model 1 accounted for 51.9% of the variance in the dependent variable(R²=0.519, P<0.001). The explanatory power of model 2 was significantly enhanced(ΔR²=0.464, P<0.01), with both the R value and R² of Model 2 being significantly higher than those of model 1. This suggested an improved regression model upon the inclusion of positive coping, negative coping, B-IPQ, and APGAR score. Conclusion: Some patients with myocardial infarction after PCI have psychosocial adaptation disorders, which are influenced by factors such as the initial myocardial infarction, exercise status, disease perception, coping strategies, and family functioning. Clinical practice should go beyond the simple biomedical model and construct a comprehensive intervention strategy that integrates cognitive restructuring, coping skills training and family support.

参考文献：

[1] FRAMPTON J,ORTENGREN A R,ZEITLER E P.Arrhythmias after acute myocardial infarction[J].Yale J Biol Med,2023,96(1):83-94.
[2] 徐芳,徐俊杰,王莉,等.左室心肌做功与STEMI患者急诊PCI术后出现左室重构的相关性研究[J].东南大学学报(医学版),2024,43(1):78-84.
[3] 唐琪,柏晓玲,楼婷,等.中青年急性心肌梗死患者不同阶段心理社会适应体验的质性研究[J].护士进修杂志,2023,38(20):1915-1919.
[4] 张晓民,郑亚男.基于行动研究法的康复运动对中老年心肌梗死PCI术后康复的影响[J].现代医学,2025,53(1):94-99.
[5] 李玉梅,顾艳荭,王洋,等.缺血性脑卒中患者心理社会适应变化轨迹潜在类别及影响因素分析的纵向研究[J].军事护理,2025,42(4):57-61.
[6] 倪平,陈京立,刘娜,等.护理研究中量性研究的样本量估计[J].中华护理杂志,2010,45(4):378-380.
[7] 叶任高,陆再英.内科学[M].6版.北京:人民卫生出版社,2004.
[8] THYGESEN K,ALPERT J S,JAFFE A S,et al.Fourth universal definition of myocardial infarction(2018)[J].J Am Coll Cardiol,2018,72(18):2231-2264.
[9] DEROGATIS L R.The psychosocial adjustment to illness scale(PAIS)[J].J Psychosom Res,1986,30(1):77-91.
[10] 姚静静.癌症患者适应水平的横断面调查及其预测因素分析[D].上海:第二军医大学,2013.
[11] 解亚宁.简易应对方式量表信度和效度的初步研究[J].中国临床心理学杂志,1998,6(2):114-115.
[12] BROADBENT E,PETRIE K J,MAIN J,et al.The brief illness perception questionnaire[J].J Psychosom Res,2006,60(6):631-637.
[13] 梅雅琪,李惠萍,杨娅娟,等.中文版疾病感知问卷简化版在女性乳腺癌患者中的信效度检验[J].护理学报,2015,22(24):11-14.
[14] SMILKSTEIN G.The family APGAR:a proposal for a family function test and its use by physicians[J].J Fam Pract,1978,6(6):1231-1239.
[15] 李耀霞,杨巧红,邱玮瑜,等.中青年急性心肌梗死患者心理社会适应不良的干预研究进展[J].护士进修杂志,2022,37(8):700-704.
[16] 唐琪,柏晓玲,楼婷,等.中青年急性心肌梗死患者心理社会适应水平及其影响因素分析[J].护士进修杂志,2022,37(5):390-393,445.
[17] 石小妍,李龙倜,王梦荷,等.中青年急性心肌梗死患者心理社会适应现状及影响因素研究[J].精神医学杂志,2024,37(1):68-72.
[18] 景肖,尹姣,郭晓岚,等.424例中青年心肌梗死患者的心理社会适应潜在剖面分析及影响因素研究[J].护理学报,2025,32(3):62-68.
[19] 袁志婷,贡欢欢,于雨,等.时机理论框架下授权赋能教育对急性心肌梗死介入术后应对方式及自我管理能力的影响[J].现代医学,2024,52(3):384-391.
[20] 郭涛.青年首发急性ST段抬高型心肌梗死的单中心研究[D].长春:吉林大学,2022.
[21] CHEN H,CHEN C,SPANOS M,et al.Exercise training maintains cardiovascular health:signaling pathways involved and potential therapeutics[J].Signal Transduct Target Ther,2022,7(1):306.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录