急性心肌梗死患者创伤后成长的预测因素  

Predictive factors of posttraumatic growth in patients with acute myocardial infarction

作　　者：赵静[1,2] 曹枫林[2] 许玉华[1] 

机构地区：[1]山东大学第二医院,济南250033 [2]山东大学护理学院,济南250012

出　　处：《中国心理卫生杂志》2015年第2期87-91,共5页Chinese Mental Health Journal

基　　金：山东省自然科学基金项目(ZR2013HM087)

摘　　要：目的：探讨急性心肌梗死（AMI）患者创伤后成长（PTG）状况及PTG的预测因素。方法：选取4所三级甲等综合医院首次确诊为AMI的患者97名,在出院前1天（T1）用创伤后成长调查量表（PTGI）、创伤后应激障碍症状问卷中文平民版（PCL-C）、亲密关系经历量表（ECR）、多伦多述情障碍量表（TAS-20）、童年期创伤问卷（CTQ）进行调查;其中43名患者在发病后第8周（T2）完成PTGI随访。结果：97名患者中,71.1%报告了PTG。43名完成随访的患者中,T1阶段32名患者存在PTG（74.4%）,T2阶段10名患者存在PTG（23.3%）。Logistic回归分析结果显示,ECR依恋焦虑得分能正向预测AMI患者T1阶段PTG的发生（OR=1.01~1.07）;CTQ情感忽视得分能负向预测AMI患者T1阶段PTG的发生（OR=0.76~0.96）,也能负向预测接受随访的AM I患者至少一个阶段PTG的发生（OR=0.67~1.00）。结论：出院前急性心肌梗死患者存在较高水平的创伤后成长,但随着时间变化其水平逐渐降低。依恋焦虑水平高的患者更容易产生较高水平的创伤后成长,而经历童年期情感忽视的患者不易产生创伤后成长。Objective： To explore the related factors of posttraumatic growth（ PTG） in patients with acute myocardial infarction. Methods： A face to face questionnaire survey（ T1） and a follow-up questionnaire survey（ T2） w ere carried out in patients w ith acute myocardial infarction in Jinan. During 5 days to 2 w eeks since attack,97 patients w ere asked to complete the Posttraumatic Grow th Inventory（ PTGI）, Posttraumatic Stress Disorder Checklist-Civilian Version（ PCL-C）,Experiences in Close Relationship（ ECR）,20-item Toronto Alexithymia Scale（ TAS-20）,and Childhood Trauma Questionnaire（ CTQ）. After 8 w eeks since attack,43 of 97 patients completed PTGI. Results： In T1,71. 1% of patients reported PTG; among 43 patients w ho completed the follow-up survey,32patients（ 74. 4%） reported PTG during T1,and 10（ 23. 3%） reported PTG during T2. Logistic regression analysis indicated that those w ith higher scores of attachment avoidance w ere more likely to have PTG during hospitalization（ OR = 1. 01- 1. 07）. How ever, those w ho experienced childhood emotional neglect w ere less likely to have PTG during hospitalization（ OR = 0. 76- 0. 96）. Emotional neglect also could predict PTG at least one time among those w ho completed the follow-up survey（ OR = 0. 67- 1. 00）. Conclusion： Most patients w ith acute myocardial infarction have PTG during hospitalization,but PTG level w ould decrease w ith time goes. Patients w ith higher attachment avoidance are prone to have PTG,w hile those w ith childhood emotional neglect are less likely to have PTG.

关 键 词：急性心肌梗死 创伤后成长 依恋 述情障碍 童年期创伤 

分 类 号：R749.92[医药卫生—神经病学与精神病学] R542.22[医药卫生—临床医学]