经皮冠状动脉介入治疗后恐动症患者不良心理健康状态的影响因素分析

doi:10.20223/j.cnki.1000-8535.2025.12.014

摘要/Abstract

摘要： 目的识别经皮冠状动脉介入治疗（PCI）后恐动症患者抑郁、焦虑和压力的影响因素。方法采用横断面研究,纳入780例行PCI术后恐动症患者。应用系列量表评估恐动症患者的不良心理健康状况、生活质量、自我感受负担、社会支持和运动自我效能,并通过问卷收集了患者的社会人口学数据。线性回归和Logistic回归用于识别抑郁、焦虑和压力等不良心理状态的影响因素,应用中介分析探索潜在的中介机制。结果 271例（34.7%）、304例（39.0%）和153例（19.6%）恐动症患者存在不同程度的抑郁、焦虑和压力。恐动症患者的抑郁、焦虑和压力水平呈正相关。线性回归和Logistic分析结果表明,较高的家庭月收入与较高的抑郁水平相关（线性回归：β为0.908和1.937;Logistic：OR为2.05和5.47）,社会支持程度与抑郁水平呈负相关（线性回归：β=-0.079;Logistic：OR=0.93）。单身/离异/寡居患者的焦虑水平显著高于已婚患者（线性回归：β=1.613;Logistic：OR=2.28）。与家庭月收入低于5 000元者相比,家庭月收入为5 000~10 000元之间的患者的压力水平较高（线性回归：β=1.065;Logistic：OR=3.14）。此外,自我感受负担较重的患者具有更高的压力水平（线性回归：β=0.077;Logistic：OR=1.05）。中介分析结果表明,焦虑和压力是社会支持/自我感受负担与抑郁之间关联的潜在中介因子。结论 PCI术后恐动症患者广泛存在心理健康问题,其家庭月收入、年龄、婚姻状况、生活方式和病史等因素对患者的不良心理健康状态具有显著影响。医务人员应关注这些患者的心理健康状况及影响因素,制定综合管理策略以改善其预后。

关键词: 经皮冠状动脉介入治疗, 恐动症, 抑郁, 焦虑, 压力, 影响因素

Abstract: Objective To identify the risk factors associated with depression,anxiety and stress in patients with kinesiophobia after percutaneous coronary intervention（PCI）．Methods In this cross-sectional study,780 patients who developed kinesiophobia after undergoing PCI were enrolled．A series of scales were used to assess the psychological health status,quality of life,self-perceived burden,social support,and exercise self-efficacy of patients with kinesiophobia,and socio-demographic data of the patients were collected through a questionnaire．Linear regression analyses and Logistic regression analyses were used to identify risk factors of adverse psychological outcomes,including depression,anxiety,and stress．Furthermore,mediation analysis was employed to explore the potential mediating mechanisms．Results Among the 780 patients with kinesiophobia,271（34.7%）,304（39.0%）and 153（19.6%）were found to have varying degrees of depression,anxiety,and stress,respectively．The levels of depression,anxiety and stress in patients with kinesiophobia were positively correlated with each other．The results of both linear regression and Logistic regression analyses indicated that higher levels of family monthly income were associated with higher levels of depression（linear：β=0.908 and 1.937;Logistic：OR=2.05 and 5.47）,while the degree of social support was negatively correlated with depression levels（linear：β=-0.079;Logistic：OR=0.93）．For patients who were single,divorced or widowed,their levels of anxiety were significantly higher than those of married patients（linear：β=1.613;Logistic：OR=2.28）．Compared to patients with a monthly household income of less than 5 000 yuan,those with a monthly income between 5 000 and 10 000 yuan reported higher levels of stress（linear：β=1.065;Logistic：OR=3.14）．Additionally,patients who perceived a higher personal burden also experienced greater stress（linear：β=0.077;Logistic：OR=1.05）．Mediation analysis indicated that anxiety and stress were potential mediating factors in the relationship between social support/self-perceived burden and depression．Conclusions This study reported the widespread psychological health issues among patients with kinesiophobia after PCI and the interactions between these issues．Factors such as monthly household income,age,marital status,lifestyle and medical history were found to be significantly associated with these negative psychological outcomes．Clinicians and nurses should focus on the psychological health and influencing factors of these patients and develop comprehensive management strategies to improve their prognosis．

Key words: percutaneous coronary intervention, kinesiophobia, depression, anxiety, stress, influencing factors

王春苑, 候小琴, 张偏, 陈小冰, 柳彩阳, 黄严荣, 刘伟濠, 詹杰, 文思敏. 经皮冠状动脉介入治疗后恐动症患者不良心理健康状态的影响因素分析[J]. 广州医药, 2025, 56(12): 1712-1723.

WANG Chunyuan, HOU Xiaoqin, ZHANG Pian, CHEN Xiaobing, LIU Caiyang, HUANG Yanrong, LIU Weihao, ZHAN Jie, WEN Simin. Analysis of the influencing factors of adverse psychological health status in patients with kinesiophobia after percutaneous coronary intervention[J]. Guangzhou Medical Journal, 2025, 56(12): 1712-1723.

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