摘要
背景倦怠是一种压力作用下的负性情感反应,目前关于倦怠与冠心病预后的研究较少。目的观察倦怠对急性冠脉综合征(ACS)患者康复过程中体力恢复的影响,探索倦怠与ACS患者康复之间的关系,为改善患者预后提供理论依据。方法本研究是一项前瞻性队列研究。选择2012年3月—2014年3月因首次发生ACS而收住昆明医科大学第一附属医院心内科的患者,病情稳定后用哥本哈根倦怠量表的一般倦怠子量表评估其倦怠水平,按倦怠水平分为高倦怠组和低倦怠组。出院后1个月时随访,用简短体力测试方案(SPPB)检测患者体力状况,并再次评估倦怠水平,按倦怠水平变化情况分为4个亚组:持续高倦怠亚组、倦怠降低亚组、持续低倦怠亚组、倦怠升高亚组,比较各亚组之间体力状态的差异,并构建多重线性回归模型进一步检验倦怠对体力恢复的影响。结果低倦怠组患者SPPB体力评分较高倦怠组患者高,差异有统计学意义(t=-3.307,P<0.01)。持续低倦怠亚组、持续高倦怠亚组、倦怠降低亚组、倦怠升高亚组,对应的SPPB评分分别为(9.7±1.6)、(7.8±1.8)、(8.6±1.8)、(7.3±2.0)分,各亚组患者出院后1个月时的SPPB评分间差异有统计学意义(F=8.933,P<0.001)。两两比较显示,持续低倦怠亚组SPPB评分高于其他亚组,差异有统计学意义(P<0.05)。以SPPB体力评分为因变量构建多重线性回归模型,结果显示,在排除年龄、性别等混杂因素后,出院时的一般倦怠子量表评分每升高1分,1个月后SPPB评分下降0.052分;出院后1个月时一般倦怠子量表评分每较基线增加1分,SPPB评分下降0.054分。结论倦怠可导致ACS患者康复过程中的体力活动下降,是ACS患者体力康复不良的独立危险因素。
Background Burnout is a kind of negative affective response under pressure, and there is a lack of researches about burnout and the prognosis of coronary heart disease at present. Objective To observe the influence of burnout on the physical strength recovery in the process of rehabilitation of patients with acute coronary syndrome（ ACS）and examine the relationship between burnout and the rehabilitation of ACS patients,in order to provide theoretical references for the improvement of prognosis of ACS patients. Methods In this prospective cohort study,we enrolled patients having first ACS onset in the Department of Cardiology, the First Affiliated Hospital of Kunming medical University from march 2012 to march 2014 as subjects,and evaluated the subjects′burnout level by using the general burnout subscale of Copenhagen Burnout Inventory after their condition got stable. According to burnout level,the subjects were assigned into high burnout group and low burnout group. During the follow-up visits to the subjects one month after discharge,physical strength of the subjects was tested by using Short Physical Performance Battery（ SPPB）and burnout level was evaluated again. According to the changes of burnout level,the subjects were divided into four subgroups：continuing high burnout subgroup, continuing low burnout subgroup, decreasing＆amp;nbsp;burnout subgroup and increasing burnout subgroup. Then physical strength status was compared among the four subgroups,and multiple linear regression model was built to further examine the influence of burnout on the recovery of physical strength. Results Low burnout group was significantly higher（t= -3. 307,P〈0. 01）than high burnout group in SPPB score. The scores of continuing low burnout subgroup, continuing high burnout subgroup, decreasing burnout subgroup and increasing burnout subgroup were（9. 7 ± 1. 6）,（7. 8 ± 1. 8）,（8. 6 ± 1. 8）and（7. 3 ± 2. 0） respectively. The four subgroups were significantly different（F=8. 933,P〈0. 001）in
出处
《中国全科医学》
CAS
CSCD
北大核心
2015年第26期3142-3147,共6页
Chinese General Practice
基金
国家自然科学基金资助项目(81360040)
云南省科技厅--昆明医科大学应用基础联合专项基金(2013FB140)
美国雅礼协会贾氏家庭健康基金(2011CF04)
