Associations between depression, resilience, and fatigue in patients with multivessel coronary disease: A cross-lag study  

冠心病多支病变患者抑郁、心理弹性和疲劳关系的交叉滞后研究

作　　者：Binbin Sun Jing Han Beibei Tian Yuexuan Xu Jin Wang Jianhui Wang 孙彬彬;韩静;田北北;徐岳旋;王瑾;王建辉

机构地区：[1]Nursing and Rehabilitation College,North China University of Science and Technology,Tangshan,Hebei,China [2]Nurse Administration Department,Tangshan Gongren Hospital,Tangshan,Hebei,China

出　　处：《International Journal of Nursing Sciences》2025年第2期144-151,共8页国际护理科学(英文)

基　　金：supported by the Medical Science Research Project of Hebei(No.20241512).

摘　　要：Objectives This study aimed to examine the associations between depression,resilience,and fatigue in patients with multivessel coronary disease and verify their causal relationships.Methods Between October 2023 and June 2024,316 patients with multivessel coronary disease were recruited from three tertiary hospitals in Tangshan,China.The Patient Health Questionnaire,Connor-Davidson Resilience Scale,and the Multidimensional Fatigue Inventory were administered to the patients on the third day of admission(T1),one month after discharge(T2),and three months after discharge(T3).Pearson correlation analysis was conducted to examine the relationships among depression,resilience,and fatigue in patients with multivessel coronary disease,and cross-lagged analysis to explore the temporal causal relationships.Results In patients with multivessel coronary disease,levels of depression and fatigue decreased from T1 to T3,while resilience scores increased during the same period.The correlation analysis revealed significant relationships among depression,resilience,and fatigue at T1,T2,and T3(P<0.01).The autoregressive paths indicated high stability over time for depression,medium stability for resilience,and low stability for fatigue.Cross-lagged paths demonstrated that depression at T1 significantly predicted fatigue at T2(β=0.461,P<0.001),and depression at T2 significantly predicted fatigue at T3(β=0.957,P<0.001).And resilience at T1 significantly predicted fatigue at T2(β=−0.271,P<0.001),and resilience at T2 significantly predicted fatigue at T3(β=−0.176,P<0.001).Additionally,resilience had a moderating effect on the relationship between depression and fatigue(β=−0.760,P<0.001).Conclusions Our study confirmed that depression and resilience predicted fatigue in patients with multivessel coronary disease.To prevent and mitigate fatigue,alleviating depressive symptoms and enhancing resilience levels in patients at an early stage is essential.目的旨在探讨冠心病多支病变患者抑郁、心理弹性和疲劳的发展轨迹及相互预测关系。方法2023年10月至2024年6月,选取唐山市3所三级甲等医院的316例冠心病多支病变患者为研究对象,采用一般资料调查表、患者健康问卷、心理弹性量表和多维疲劳量表在患者人院后第3天(T1)出院后1个月(T2)及3个月(T3)进行调查。采用Pearson相关分析探讨抑郁、心理弹性与疲劳的相关性,使用交叉滞后模型分析三者之间的相互预测关系。结果从T1到T3,冠心病多支病变患者的抑郁和疲劳程度下降,而心理弹性上升。抑郁、心理弹性和疲劳在3个时间点均显著相关(P<0.01)。交叉滞后模型显示,T1的抑郁显著预测T2的疲劳(P<0.001),T2的抑郁显著预测T3的疲劳(P<0.001);T1的心理弹性显著预测T2的疲劳(P<0.001),T2的心理弹性显著预测T3的疲劳(P<0.001)。此外,T2的心理弹性对T1的抑郁和T3的疲劳有调节作用(P<0.001)。结论该研究证实冠心病多支病变患者的抑郁和心理弹性可预测疲劳,医护人员应制订针对性干预措施以预防和减轻疲劳。

关 键 词：Coronary heart disease DEPRESSION FATIGUE RESILIENCE Cross-lag analysis 

分 类 号：R749.92[医药卫生—神经病学与精神病学]