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韧性与健康相关的生活质量密切相关,但在急性心肌梗死后 1 年,对就业人员的工作相关压力没有缓冲作用。

Resilience is strongly associated with health-related quality of life but does not buffer work-related stress in employed persons 1 year after acute myocardial infarction.

机构信息

Chair of Epidemiology, UNIKA-T Augsburg, Ludwig-Maximilians-Universität München, Neusässer Str. 47, 86156, Augsburg, Germany.

Central Hospital of Augsburg, MONICA/KORA Myocardial Infarction Registry, Augsburg, Germany.

出版信息

Qual Life Res. 2020 Feb;29(2):391-401. doi: 10.1007/s11136-019-02306-6. Epub 2019 Sep 20.

Abstract

PURPOSE

Resilience may facilitate the adaptation after experiencing a severe disease such as acute myocardial infarction (AMI) and attenuate the negative effects of stress on health-related quality of life (HRQOL). However, it is unclear so far whether resilience moderates a negative association between work-related stress and HRQOL in employed patients after AMI.

METHODS

Patients with confirmed AMI and regular paid employment admitted to a hospital in the study region of the MONICA/KORA Myocardial Infarction Registry, Germany (04/2014-06/2017) were included and completed questionnaires during their hospital stay and 6 and 12 months after discharge. The Resilience Questionnaire (RS-11) and the Effort-Reward Imbalance (ERI) Questionnaire were used to assess trait resilience and ERI, respectively. HRQOL was measured by the Short Form 36 Health Survey (SF-36) mental and physical component summary scales. Generalized estimating equations (GEE) adjusted for relevant potential confounding variables (demographic, social, stress-related, and clinical) were used to determine the association between resilience and HRQOL in the study course.

RESULTS

From the 346 patients enrolled in the study, 270 patients (78.0%) had completed all surveys. High baseline trait resilience was significantly and independently associated with high physical HRQOL (ß = 0.15, p < 0.0001) and high mental HRQOL (ß = 0.37, p < 0.0001) 1 year post AMI. No significant interaction effects between trait resilience and ERI were found in the physical HRQOL GEE model (ß = 0.05, p = 0.7241) and in the mental HRQOL model (ß = 0.05, p = 0.3478).

CONCLUSIONS

The results demonstrated that trait resilience is independently and strongly related with post-AMI HRQOL but does not moderate the association between ERI and HRQOL.

摘要

目的

韧性可能有助于在经历严重疾病(如急性心肌梗死 [AMI])后适应,并减轻压力对健康相关生活质量(HRQOL)的负面影响。然而,到目前为止,还不清楚韧性是否会调节 AMI 后就业患者工作相关压力与 HRQOL 之间的负相关关系。

方法

研究纳入了德国 MONICA/KORA 心肌梗死登记研究地区一家医院收治的确诊为 AMI 且有固定薪酬工作的患者(2014 年 4 月至 2017 年 6 月),并在住院期间以及出院后 6 个月和 12 个月完成问卷调查。使用韧性问卷(RS-11)和努力-回报失衡(ERI)问卷分别评估特质韧性和 ERI。使用健康调查简表 36 项(SF-36)心理和生理成分综合量表测量 HRQOL。使用广义估计方程(GEE)调整相关潜在混杂变量(人口统计学、社会、压力相关和临床),以确定研究过程中韧性与 HRQOL 之间的关联。

结果

在纳入研究的 346 名患者中,有 270 名患者(78.0%)完成了所有调查。基线特质韧性高与 AMI 后 1 年时较高的生理 HRQOL(β=0.15,p<0.0001)和较高的心理 HRQOL(β=0.37,p<0.0001)显著且独立相关。在生理 HRQOL GEE 模型(β=0.05,p=0.7241)和心理 HRQOL 模型(β=0.05,p=0.3478)中,特质韧性与 ERI 之间均未发现显著的交互效应。

结论

研究结果表明,特质韧性与 AMI 后 HRQOL 显著且密切相关,但不能调节 ERI 与 HRQOL 之间的关系。

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