Associations Between Psychological Factors and Adherence to Health Behaviors After Percutaneous Coronary Intervention: The Role of Cardiac Rehabilitation.

IF 3.6 2区 心理学 Q1 PSYCHOLOGY, MULTIDISCIPLINARY
Emma R Douma, Willem J Kop, Nina Kupper
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引用次数: 0

Abstract

Background: Cardiac rehabilitation (CR) participation after percutaneous coronary intervention (PCI) for coronary heart disease lowers the disease burden and risk of recurrent cardiac events. Examining psychological factors may improve post-PCI health behavior adherence.

Purpose: To determine whether psychological factors are associated with post-PCI health behavior adherence, and the role of CR participation.

Methods: Data from 1,682 patients (22.1% female, Mage = 64.0, SDage = 10.5 years) from the THORESCI cohort were included. Adjusted mixed models were used to examine associations between psychological factors and the 1-year course of health behaviors, using interactions to test for moderation by CR participation.

Results: Psychological factors were associated with the trajectories of adherence to medical advice, exercise, and diet. The strongest association found was between optimism and the trajectory of dietary adherence (B: = -0.09, p = .026). Patients with high optimism levels had a worse trajectory of dietary adherence compared to patients with low to middle optimism levels. Participation in CR buffered the associations of high anxiety, pessimism, and low to middle resilience, but strengthened the associations of high stress in the past year with the probability of smoking.

Conclusions: Psychological factors are associated with post-PCI health behavior adherence, but the pattern of associations is complex. Patients with high levels of anxiety, pessimism, and low to middle resilience levels may disproportionately benefit from CR. Cardiac rehabilitation programs could consider this to improve post-PCI health behavior adherence.

Clinical trials registration #: NCT02621216.

经皮冠状动脉介入治疗后心理因素与坚持健康行为之间的关系:心脏康复的作用。
背景:冠心病经皮冠状动脉介入治疗(PCI)后参与心脏康复(CR)可降低疾病负担和复发心脏事件的风险。目的:确定心理因素是否与经皮冠状动脉介入术后健康行为的坚持有关,以及参与心脏康复的作用:方法:纳入 THORESCI 队列中 1682 名患者(22.1% 为女性,平均年龄 = 64.0 岁,平均年龄 = 10.5 岁)的数据。使用调整后的混合模型来检验心理因素与健康行为 1 年历程之间的关联,并使用交互作用来检验 CR 参与的调节作用:结果:心理因素与遵从医嘱、运动和饮食的轨迹有关。乐观情绪与饮食依从性轨迹之间的关系最为密切(B:=-0.09,P=0.026)。与中低度乐观的患者相比,高度乐观的患者的饮食依从性更差。参与 CR 可以缓冲高度焦虑、悲观和中低复原力之间的关联,但加强了过去一年中高度压力与吸烟概率之间的关联:心理因素与PCI术后的健康行为依从性有关,但其关联模式非常复杂。焦虑、悲观程度高、抗压能力处于中低水平的患者可能更容易从心脏康复中获益。心脏康复项目可以考虑这一点,以提高PCI术后健康行为的依从性。临床试验注册号:NCT02621216。
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来源期刊
Annals of Behavioral Medicine
Annals of Behavioral Medicine PSYCHOLOGY, MULTIDISCIPLINARY-
CiteScore
7.00
自引率
5.30%
发文量
65
期刊介绍: Annals of Behavioral Medicine aims to foster the exchange of knowledge derived from the disciplines involved in the field of behavioral medicine, and the integration of biological, psychosocial, and behavioral factors and principles as they relate to such areas as health promotion, disease prevention, risk factor modification, disease progression, adjustment and adaptation to physical disorders, and rehabilitation. To achieve these goals, much of the journal is devoted to the publication of original empirical articles including reports of randomized controlled trials, observational studies, or other basic and clinical investigations. Integrative reviews of the evidence for the application of behavioral interventions in health care will also be provided. .
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