作者：陈兴萍，施平

单位：

441021 湖北省襄阳市中心医院（湖北文理学院附属医院）；通信作者：施平，E-mail：shiping1279@163.com

Units：

Xiangyang Central Hospital（the Affiliated Hospital of Hubei University of Arts and Sciences），Xiangyang 441021，China；Corresponding author：SHI Ping，E-mail：shiping1279@163.com

关键词：

冠心病；经皮冠状动脉介入治疗；创伤后成长；心理弹性；反刍性沉思

Keywords：

Coronary heart disease；Percutaneous coronary intervention；Post traumatic growth；Psychologicalelasticity；Rumination

CLC：

R 541.4

DOI：

DOI：10.3969/j.issn.1008-5971.2020.01.004

Funds：

摘要：

背景　随着冠心病发病率升高、行经皮冠状动脉介入治疗（PCI）的患者数量增多，创伤后成长（PTG）等心理问题逐渐凸显，但心理弹性、反刍性沉思与行 PCI 的冠心病患者 PTG 的关系尚不明确。目的　分析心理弹性、反刍性沉思与行 PCI 的冠心病患者 PTG 的相关性。方法　选取 2016 年 8 月—2017 年 10 月在襄阳市中心医院确诊并行 PCI 的冠心病患者 110 例，采用自制一般资料调查问卷收集其一般资料并进行创伤后成长评定量表（PTGI）、心理弹性量表（CD-RISC）、简体中文版事件相关反刍性沉思问卷（C-ERRI）评分。CD-RISC 评分、C-ERRI 评分与行PCI的冠心病患者PTGI评分的相关性分析采用Pearson相关分析。结果　（1）共发放110份问卷，回收有效问卷110份，有效回收率为 100.0%。110 例患者 PTGI 总分为（63.98±12.27）分，其中人生感悟评分为（12.84±3.34）分、个人力量评分为（10.51±3.28）分、新的可能性评分为（10.70±4.32）分、与他人关系评分为（19.65±5.58）分、自我改变评分为（8.36±3.17）分。（2）110 例患者 CD-RISC 总分为（60.50±12.08）分，其中自强、坚韧、乐观评分分别为（23.82±3.52）、（22.98±2.17）、（9.87±1.79）分；C-ERRI 总分为（27.02±11.98）分，其中侵入性、目的性反刍性沉思评分分别为（1.62±0.38）、（1.59±0.59）分。（3）不同性别、家庭月收入、病情知晓程度及是否在职患者人生感悟、个人力量、新的可能性、与他人关系、自我改变评分及 PTGI 总分比较，差异无统计学意义（P>0.05）；不同年龄、文化程度患者人生感悟、个人力量、新的可能性、与他人关系、自我改变评分及 PTGI 总分比较，差异有统计学意义（P<0.05）。（4）Pearson 相关分析结果显示，CD-RISC 中自强、坚韧、乐观评分及其总分与 PTGI 中人生感悟（r 值分别为 0.569、0.466、0.372、0.337）、个人力量（r 值分别为 0.600、0.451、0.410、0.374）、新的可能性（r 值分别为 0.622、0.462、0.341、0.368）、与他人关系（r 值分别为 0.595、0.466、0.369、0.364）、自我改变（r值分别为 0.619、0.457、0.409、0.380）评分及其总分（r 值分别为 0.604、0.463、0.377、0.366）呈正相关（P<0.05）；C-ERRI 中入侵性反刍性沉思评分与 PTGI 中人生感悟（r=-0.540）、个人力量（r=-0.574）、新的可能性（r=-0.543）、与他人关系（r=-0.547）、自我改变（r=-0.589）评分及其总分（r=-0.558）呈负相关（P<0.05），目的性反刍性沉思评分及其总分与 PTGI 中人生感悟（r 值分别为 0.505、0.429）、个人力量（r 值分别为 0.557、0.416）、新的可能性（r 值分别为 0.526、0.450）、与他人关系（r 值分别为 0.533、0.427）、自我改变（r 值分别为 0.522、0.410）评分及其总分（r 值分别为 0.536、0.430）呈正相关（P<0.05）。结论　年龄、文化程度、心理弹性、反刍性沉思与行 PCI的冠心病患者 PTG 有关。

Abstract：

Background　As morbidity of coronary heart disease and number of patients underwent percutaneouscoronary intervention（PCI）increasing，psychological problems such as posttraumatic growth（PTG）begin to appear，however relations of psychological elasticity and rumination with PTG in postoperative coronary heart disease patients treated byPCI are not yet clear. Objective　To analyze the correlations of psychological elasticity and rumination with PTG in postoperativecoronary heart disease patients treated by PCI. Methods　A total of 110 postoperative coronary heart disease patients treated byPCI were selected in Xiangyang Central Hospital from August 2016 to October 2017，general information was collected by self-made General Information Questionnaire，and then PTGI score，CD-RISC score and C-ERRI score were evaluated. Pearsoncorrelation analysis was used to analyze the correlations of CD-RISC score and C-ERRI score with PTGI score in postoperativecoronary heart disease patients treated by PCI. Results　（1）The effective response rate was 100%（110/110）. Of the110 patients，total score of PTGI was（63.98±12.27），insights on life score was（12.84±3.34），personal power scorewas（10.51±3.28），new possibility score was（10.70±4.32），relationship with others score was（19.65±5.58），and self-change score was（8.36±3.17）.（2）Of the 110 patients，total score of CD-RISC was（60.50±12.08），self-improvement score was（23.82±3.52），tenacity score was（22.98±2.17），optimism score was（9.87±1.79）；totalscore of C-ERRI was （27.02±11.98），intrusive and purposive meditation score was（1.62±0.38）and（1.59±0.59），respectively.（3）There was no statistically significant difference in insights on life score，personal power score，new possibilityscore，relationship with others score，self-change score or total score of PTGI in patients with different gender，with differentmonthly household income，with different degrees of disease awareness，whether employed or not（P>0.05），while therewas statistically significantly difference in insights on life score，personal power score，new possibility score，relationship withothers score，self-change score or total score of PTGI in patients of different age，with different educational level（P<0.05）.（4）Pearson correlation analysis results showed that，self-improvement score，tenacity score，optimism score and total scoreof CD-RISC was positively correlated with insights on life score（r value was 0.569，0.466，0.372，0.337），personal powerscore（r value was 0.600，0.451，0.410，0.374），new possibility score（r value was 0.622，0.462，0.341，0.368），relationship with others score（r value was 0.595，0.466，0.369，0.364），self-change score（r value was 0.619，0.457，0.409，0.380）and total score of PTGI（r value was 0.604，0.463，0.377，0.366）in postoperative coronary heart disease patientstreated by PCI，respectively（P<0.05）；invasive meditation score was negatively correlated with insights on life score（r=-0.540），personal power score（r=-0.574），new possibility score（r=-0.543），relationship with others score（r=-0.547），self-change score（r=-0.589）and total score of C-ERRI（r=-0.558）in postoperative coronary heart disease patients treated byPCI，respectively（P<0.05），while Purposive meditation score and total score of C-ERRI was positively correlated with insightson life score（r value was 0.505，0.429），personal power score（r value was 0.557，0.416），new possibility score（r value was 0.526，0.450），relationship with others score（r value was 0.533，0.427），self-change score（r ralue was 0.522，0.410）and total scoreof PTGI（r ralue was 0.536，0.430），respectively（P<0.05）. Conclusion　Age，educational level，psychological elasticity andrumination are significantly correlated with PTG in postoperative coronary heart disease patients treated by PCI.

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