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首页> 外文学位 >Anxiety and depression in cardiac patients: A psychometric evaluation of the Hospital Anxiety and Depression Scale; HADS, and a longitudinal investigation of exercise, gender and affective functioning.
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Anxiety and depression in cardiac patients: A psychometric evaluation of the Hospital Anxiety and Depression Scale; HADS, and a longitudinal investigation of exercise, gender and affective functioning.

机译：心脏病患者的焦虑和抑郁：医院焦虑和抑郁量表的心理测量评估； HADS，以及运动，性别和情感功能的纵向调查。

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摘要

Gender differences are apparent in both the affective functioning and exercise behaviour of cardiac patients. Specifically, female cardiac patients demonstrate more anxiety and depression, and reduced exercise compared to males. Accordingly, gender appropriate screening measures and interventions are needed. In studying a diverse sample of cardiac patients over two years, the objectives of the first investigation were to (1) examine the factor structure of the HADS, and (2) test measurement invariance between genders. The aims of the second study were to (1) examine the prevalence of autonomic anxiety, negative affect and depression, and (2) determine whether gender moderated the exercise/affective relationships, and (3) evaluate whether exercise mediated the gender/affective relationships. 801 cardiac inpatients completed questionnaires including the HADS at baseline, 6 months, 12 months and 24 months post-discharge. Confirmatory factor analysis consistently supported a three-factor structure of the HADS, with the best fitting model comprised of negative affect, autonomic anxiety and depression. Structural equation modeling showed that the HADS was invariant by gender among cardiac patients. Repeated measures analysis of covariance (ANCOVA) revealed that female cardiac patients had greater autonomic anxiety, negative affect and depression and reduced exercise compared to male cardiac patients at all time points. Although exercise was significantly related to affective outcomes at various time points for both men and women, gender did not moderate any of the exercise/affective relationships, and exercise did not mediate any of the gender/affective relationships. In summary, the HADS can be appropriately used with both male and female cardiac patients to assess three domains of psychological distress. Future investigations should consider the predictive validity and relevance of the HADS subscales with respect to diagnostic distinctions and clinical outcomes among cardiac patients and other clinical populations. In addition, further research is needed to clarify the complex relationships between gender and the affective functioning of cardiac patients.
机译：心脏病患者的情感功能和运动行为均存在性别差异。具体而言，与男性相比，女性心脏病患者表现出更多的焦虑和沮丧感，并且运动量减少。因此，需要适当的性别筛选措施和干预措施。在研究两年以上的各种心脏病患者样本时，首次调查的目的是（1）检查HADS的因子结构，以及（2）检验性别之间的测量变异性。第二项研究的目的是（1）检查植物性焦虑，负面影响和抑郁的患病率，（2）确定性别是否调节了运动/情感关系，（3）评估运动是否介导了性别/情感关系。 801名心脏病住院患者完成了包括基线时，出院后6个月，12个月和24个月的HADS在内的问卷。验证性因素分析始终支持HADS的三因素结构，最佳拟合模型包括负面影响，植物性焦虑和抑郁。结构方程模型表明，心脏病患者的HADS在性别方面不变。重复测量的协方差分析（ANCOVA）显示，与男性心脏患者相比，女性心脏患者在所有时间点均具有更大的自主性焦虑，负面影响和沮丧感，并且运动量减少。尽管锻炼在男女的各个时间点都与情感结局显着相关，但是性别并没有调节任何锻炼/情感关系，锻炼也没有调解任何性别/情感关系。总而言之，HADS可以适当地用于男性和女性心脏病患者，以评估心理困扰的三个方面。未来的研究应考虑到HADS量表在心脏病患者和其他临床人群之间的诊断区别和临床结果方面的预测有效性和相关性。另外，需要进一步的研究来阐明性别与心脏病患者的情感功能之间的复杂关系。

著录项

  • 作者

    Hunt-Shanks, Tiffany T.;

  • 作者单位

    University of Ottawa (Canada).;

  • 授予单位 University of Ottawa (Canada).;
  • 学科 Health Sciences Medicine and Surgery.;Psychology Clinical.
  • 学位 Ph.D.
  • 年度 2009
  • 页码 135 p.
  • 总页数 135
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 医学心理学、病理心理学;
  • 关键词

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