摘要
目的探析老年冠心病患者心脏康复运动期运动恐惧的相关因素,并评价认知行为疗法对改善运动恐惧和促进康复的效果。方法纳入2023年10月至2024年10月空军军医大学西京医院收治的老年冠心病患者352例,采用运动恐惧量表(TSK-11)评估患者心脏康复运动恐惧情况,并对运动恐惧患者进行随机分组,分别给予常规干预(常规组,n=82)和认知行为干预(研究组,n=82),观察两组的干预效果。结果46.59%(164/352)的老年冠心病患者存在不同程度的运动恐惧。运动恐惧患者中女性、离异/丧偶、血运重建、家庭关系不和睦占比及抑郁症状群量表(PHQ9)、广泛焦虑量表(GAD7)评分高于非运动恐惧患者(P<0.05),自我效能感量表(GSES)、社会支持评定量表(SSRS)评分低于非运动恐惧患者(P<0.05)。Logistic回归分析显示:女性、离异/丧偶、家庭关系不和睦、血运重建及PHQ9、TSK-11、GAD7、GSES、SSRS评分与运动恐惧相关(P<0.05)。干预后,研究组TSK-11、PHQ9、GAD7评分低于常规组,GSES、SSRS评分和6 min步行试验距离及心肺运动试验中峰值摄氧量、无氧阈值高于常规组(P<0.05)。结论老年冠心病患者心脏康复运动恐惧与性别、血运重建、社会心理因素等相关,临床应根据情况给予认知行为干预,引导患者规律进行康复运动,以促进心肺功能改善。
Objective To explore and analyze the related factors of kinesiophobia in elderly patients with coronary heart disease(CHD)during cardiac rehabilitation exercise period,and to evaluate the effect of cognitive behavior therapy on improving kinesiophobia and promoting rehabilitation.Methods A total of 352 elderly patients with CHD admitted to the hospital were included from October 2023 to October 2024.Tampa Scale for Kinesiophobia-11(TSK-11)was adopted to evaluate the kinesiophobia status.Patients with kinesiophobia were randomly grouped.Routine intervention(routine group,n=82)and cognitive behavior intervention(study group,n=82)were implemented respectively.The intervention effects were observed in both groups.Results Among the 352 patients,46.59%(164/352)of elderly patients with coronary heart disease had different degrees of kinesiophobia.The proportions of female,divorced/widowed,revascularization and family relationship disharmony and scores of Patient Health Questionnaire(PHQ9)and Generalized Anxiety Disorder Scale(GAD7)in patients with kinesiophobia were higher than those in patients without kinesiophobia(P<0.05)while the scores of General Self-Efficacy Scale(GSES)and Social Support Rating Scale(SSRS)were lower compared with those in patients without kinesiophobia(P<0.05).Logistic regression analysis found that female,divorced/widowed,family relationship disharmony,revascularization and scores of PHQ9,TSK-11,GAD7,GSES and SSRS were related to kinesiophobia(P<0.05).After intervention,the scores of TSK-11,PHQ9 and GAD7 in the study group were lower while the scores of GSES and SSRS,6 min walking test distance,and cardiopulmonary exercise test peak oxygen uptake and anaerobic threshold were higher compared to the routine group(P<0.05).Conclusion The kinesiophobia in elderly patients with CHD during cardiac rehabilitation is related to gender,revascularization and psychosocial factors.Clinically,cognitive behavior intervention should be provided according to the situation and guided to carry out rehabilitation exercise regularly so as to promote improvement of cardiopulmonary function.
作者
仝子言
张亚敏
王汝涛
高好考
TONG Ziyan;ZHANG Yamin;WANG Rutao;GAO Haokao(Department of Cardiovascular Medicine,Xijing Hospital,Air Fourth Medical University,Xi′an,Shaanxi 710032,China)
出处
《公共卫生与预防医学》
2025年第5期149-153,共5页
Journal of Public Health and Preventive Medicine
基金
国家自然科学基金项目(82470257)
陕西省重点研发计划项目(S2024-YF-YBGY-1150)。
关键词
老年人
冠心病
康复运动
运动恐惧
认知行为疗法
Elderly
Coronary heart disease
Rehabilitation exercise
Kinesiophobia
Cognitive behavior therapy
作者简介
第一作者:仝子言,本科,护师,主要研究方向:心脏及血管疾病发病机制和预防策略;通信作者:张亚敏,Email:270277955@qq.com。
