冠心病患者心因性焦虑现状及影响因素的路径分析  

Path analysis of the status and influencing factors of heart-focused anxiety in patients with coronary heart disease

作　　者：李佳敏 李岩 秦静雯 周思欣 龚开政 LI Jia-min;LI Yan;QIN Jing-wen;ZHOU Si-xin;GONG Kai-zheng(School of nursing and school of public health,Yangzhou University,Yangzhou,Jiangsu 225009,China;不详)

机构地区：[1]扬州大学护理学院·公共卫生学院,江苏扬州225009 [2]扬州大学附属医院心血管内科,江苏扬州225012

出　　处：《现代预防医学》2025年第1期15-20,共6页Modern Preventive Medicine

基　　金：江苏省医学重点学科建设单位(JSDW202251);扬州市重大心血管疾病防治前沿创新重点实验室(YZ2022171)。

摘　　要：目的 了解冠心病患者心因性焦虑(heart-focused anxiety, HFA)现状,构建基于应激作用过程理论的结构方程模型,分析HFA的影响因素及各变量间的相关性。方法 采用便利抽样法选取2023年12月—2024年6月于扬州大学附属医院心内科就诊的247例冠心病患者进行问卷调查。采用结构方程模型探讨冠心病患者HFA影响因素及路径分析。结果 共纳入247例冠心病患者,其心脏焦虑问卷总分为(25.77±8.39)分,HFA检出率为33.2%(82例)。结构方程模型显示,积极应对、消极应对、社会支持、疾病感知对HFA产生直接影响,直接效应值分别为-0.226、0.275、-0.272、0.204(均P<0.01)。社会支持对HFA产生间接负向效应值为-0.187(95%CI:-0.302~-0.096),占总效应的40.74%;疾病感知对HFA产生间接正向效应值为0.335(95%CI:0.242~0.385),占总效应的62.27%。结论 冠心病患者HFA症状较为常见,医护人员可通过引导患者建立正确的疾病认知、采取积极的应对方式、主动寻求社会支持等措施降低患者的HFA水平。Objective To understand the status of heart-focused anxiety(HFA)in patients with coronary heart disease and to construct a structural equation model based on the theory of stress processes to analyze the influencing factors and correlations among various variables.Methods A convenience sampling method was used to select 247 patients with coronary heart disease who visited the Department of Cardiology at the Affiliated Hospital of Yangzhou University from December 2023 to June 2024 for a questionnaire survey.A structural equation model was employed to investigate the influencing factors and path analysis of HFA in these patients.Results A total of 247 patients with coronary heart disease were included,with a mean score of(25.77±8.39)on the heart anxiety questionnaire,and the HFA detection rate was 33.2%(82 cases).The structural equation model indicated that positive coping,negative coping,social support,and disease perception had direct effects on HFA,with effect values of-0.226,0.275,-0.272,and 0.204,respectively(all P<0.01).Social support had an indirect negative effect value on HFA of-0.187(95%CI:-0.302 to-0.096),accounting for 40.74%of the total effect.The disease perception had an indirect positive effect value on HFA of 0.335(95%CI:0.242 to 0.385),accounting for 62.27%of the total effect.Conclusion HFA symptoms are relatively common in patients with coronary heart disease.Healthcare professionals can reduce the level of HFA in patients by guiding them to establish correct disease cognition,adopt positive coping strategies,and actively seek social support.

关 键 词：冠心病 心因性焦虑 影响因素 结构方程模型 

分 类 号：R54[医药卫生—心血管疾病] R749.4[医药卫生—内科学]