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首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >Self-efficacy and health status in patients with coronary heart disease: findings from the heart and soul study.
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Self-efficacy and health status in patients with coronary heart disease: findings from the heart and soul study.

机译：冠心病患者的自我效能和健康状况：心脏和灵魂研究的结果。

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OBJECTIVE: To examine the relationship between cardiac self-efficacy and health status, including symptom burden, physical limitation, quality of life, and overall health among outpatients with stable coronary heart disease (CHD). We hypothesized that lower self-efficacy would predict worse health status, independent of CHD severity and depression. METHODS: We performed a cross-sectional study of 1024 outpatients with CHD, who were recruited between 2000 and 2002 for the Heart and Soul Study. We administered a validated measure of cardiac self-efficacy, assessed cardiac function using exercise treadmill testing with stress echocardiography, and measured depressive symptoms using the Patient Health Questionnaire. Health status outcomes (symptom burden, physical limitation, and quality of life) were assessed using the Seattle Angina Questionnaire, and overall health was measured as fair or poor (versus good, very good, or excellent). RESULTS: After adjustment for CHD severity and depressive symptoms, each standard deviation (4.5-point) decrease in self-efficacy score was independently associated with greater symptom burden (adjusted odds ratio (OR) = 2.1, p = .001), greater physical limitation (OR = 1.8, p < .0001), worse quality of life (OR = 1.6, p < .0001), and worse overall health (OR = 1.9, p < .0001). Depressive symptoms and poor treadmill exercise capacity were also associated with poor health status, but left ventricular ejection fraction and ischemia were not. CONCLUSIONS: Among patients with CHD, low cardiac self-efficacy is associated with poor health status, independent of CHD severity and depressive symptoms. Further study should examine if self-efficacy constitutes a useful target for cardiovascular disease management interventions.
机译：目的：研究稳定的冠心病（CHD）门诊患者的心脏自我效能与健康状况之间的关系，包括症状负担，身体限制，生活质量和整体健康状况。我们假设较低的自我效能感会预测健康状况的恶化，而与冠心病的严重程度和抑郁无关。方法：我们进行了一项横断面研究，对2000年至2002年在心脏与灵魂研究中招募的1024名CHD门诊患者进行了研究。我们进行了一项经过验证的心脏自我效能测量，通过运动跑步机测试和压力超声心动图评估了心脏功能，并使用《患者健康问卷》测量了抑郁症状。使用西雅图心绞痛问卷对健康状况的结果（症状负担，身体限制和生活质量）进行了评估，总体健康状况被评估为公平或较差（相对于良好，非常好或极好）。结果：在对冠心病严重程度和抑郁症状进行调整后，自我效能得分的每个标准差（4.5分）降低都与更大的症状负担相关（校正比值比（OR）= 2.1，p = .001），更大的体力限制（OR = 1.8，p <.0001），较差的生活质量（OR = 1.6，p <.0001）和较差的整体健康状况（OR = 1.9，p <.0001）。抑郁症状和跑步机运动能力差也与健康状况差有关，但左心室射血分数和缺血则不相关。结论：在冠心病患者中，心脏自我效能低与健康状况差有关，与冠心病严重程度和抑郁症状无关。进一步的研究应检查自我效能是否构成心血管疾病管理干预措施的有用目标。

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