经皮冠状动脉介入术后患者正念注意觉知水平在睡眠质量与运动耐力间的中介效应  

Mediation effect of mindful attention awareness level on sleep quality and exercise endurance of patients after percutaneous coronary intervention

作　　者：张燕[1] 杨智清 姚毓岚 张婷婷[1] ZHANG Yan;YANG Zhi-qing;YAO Yu-lan;ZHANG Ting-ting(The First Ward,Department of Cardiovasology(Ⅱ),Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Department of Nursing,Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China)

机构地区：[1]上海交通大学医学院附属新华医院心血管二科一病区,上海200092 [2]上海交通大学医学院附属精神卫生中心护理部,上海200030

出　　处：《海军军医大学学报》2022年第10期1149-1154,共6页Academic Journal of Naval Medical University

基　　金：上海市护理质控中心项目(ZK2020007);上海交通大学医学院护理学科青年人才项目;上海交通大学医学院附属新华医院护理学科人才培养计划(HLXKRC2021005).

摘　　要：目的调查冠心病患者经皮冠状动脉介入术(PCI)后的睡眠质量、正念注意觉知水平、运动耐力水平,探讨正念注意觉知水平在睡眠质量与运动耐力间的中介效应。方法采用便利抽样法抽取2020年8月至2021年7月在上海交通大学医学院附属新华医院心血管内科行心肺运动试验(CPET)的93例PCI后冠心病患者,采用一般资料问卷、正念注意觉知量表(MAAS)、匹兹堡睡眠质量指数量表(PSQI)调查患者的一般情况、正念注意觉知水平及睡眠质量,采用CPET结果的最大摄氧量(VO_(2 max))评估患者的运动耐力。结果回收有效问卷89份。89例患者MAAS得分为65.00(60.50,70.50)分,PSQI得分为8.00(6.00,9.00)分,VO_(2 max)为(1203.29±368.12)mL/min。患者PSQI得分与VO_(2 max)呈负相关(r_(s)=-0.482,P<0.01),MAAS得分与PSQI得分呈负相关(r_(s)=-0.402,P<0.01),MAAS得分与VO_(2 max)呈正相关(r_(s)=0.454,P<0.01);女性患者及罹患陈旧性心肌梗死患者3个变量间的相关性更强(|r_(s)|均>0.5,P均<0.01)。中介效应分析结果显示,PCI后冠心病患者正念注意觉知水平在睡眠质量与运动耐力间存在部分中介效应(中介效应值为-23.802,95%CI-46.461~-7.277),中介效应占总效应的比例为25.29%。结论PCI后冠心病患者睡眠质量对运动耐力有直接预测作用,正念注意觉知水平在睡眠质量与运动耐力间起部分中介作用。Objective To investigate the sleep quality,mindful attentional awareness level and exercise endurance in patients with coronary artery disease after percutaneous coronary intervention(PCI),and to explore the mediating effect of mindful attention awareness level between sleep quality and exercise endurance.Methods Convenience sampling method was used to select 93 post-PCI patients who underwent cardiopulmonary exercise test(CPET)in Department of Cardiovasology,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from Aug.2020 to Jul.2021.The general information questionnaire,mindful attention awareness scale(MAAS)and Pittsburgh sleep quality index scale(PSQI)were used to investigate the patients’general condition,the level of mindful attention awareness and sleep quality of the patients.The maximal oxygen uptake(VO_(2 max))from the results of the CPET was used to assess the patients’exercise endurance.Results Totally 89 valid questionnaires were collected.The MAAS score of the 89 patients was 65.00(60.50,70.50),the PSQI score was 8.00(6.00,9.00),and the VO_(2 max) was(1203.29±368.12)mL/min.The PSQI score was negatively correlated with the VO_(2 max)(r_(s)=-0.482,P<0.01),the MAAS score was negatively correlated with the PSQI score(r_(s)=-0.402,P<0.01),and the MAAS score was positively correlated with the VO_(2 max)(r_(s)=0.454,P<0.01);among them,female patients or ones with previous myocardial infarction showed higher correlation among the 3 variables(|r_(s)|>0.5,P<0.01).The results of the mediation effect analysis showed that the level of mindfulness had a partial mediation effect between sleep quality and exercise endurance in patients with coronary heart disease after PCI(the mediation effect value was-23.802,95%confidence interval-46.461--7.277),and the mediation effect accounted for 25.29%of the total effect.Conclusion Sleep quality has a predictive effect on exercise endurance in patients with coronary artery disease after PCI,and the level of mindful attention awareness plays a

关 键 词：冠心病 睡眠质量 正念注意觉知 运动耐力 中介效应 

分 类 号：R541.4[医药卫生—心血管疾病]