通过压力管理培训增强心脏康复:随机临床有效性试验
James A Blumenthal1, Andrew Sherwood2, Patrick J Smith2
1From the Departments of Psychiatry and Behavioral Sciences (J.A.B., A.S., P.J.S., L.W., S.M., K.I.) and Medicine (W.E.K.), Duke University Medical Center, Durham, NC; and Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill (P.M., A.H.). blume003@mc.duke.edu.
将压力管理培训 (SMT) 添加到心脏康复 (CR) 中,显著降低了患者的压力和改善了健康结果. 这表明SMT应该是CR的常规部分,以获得心脏病患者更好的结果.
科学领域:
- 心脏病学
- 心理学
- 预防医学
背景情况:
- 心脏康复 (CR) 是冠心病患者的标准护理.
- 高压力与慢性心脏病的健康状况恶化有关.
- 压力管理培训 (SMT) 并不经常被纳入CR.
研究的目的:
- 评估SMT添加到CR对心血管疾病患者的压力水平和临床结果的影响.
- 为了比较综合CR与与SMT结合的CR (CR+SMT).
主要方法:
- 151名心血管疾病门诊患者 (36至84岁) 被随机分配到12周的CR或CR+SMT.
- 在治疗前和治疗后评估了压力和心脏病生物标志物.
- 一个没有CR的组作为比较.
- 临床事件的随访时间长达5. 3年.
主要成果:
- 由于焦虑和痛苦的减少,CR+SMT显示复合压力水平降低较大 (P=0.022).
- 这两个CR组的CHD生物标志物相对改善.
- 与单独使用CR (33%;HR=0. 49) 相比,CR+SMT组的临床事件发生率较低.
- 两组CR的事件率都低于没有CR的组 (47%).
结论:
- 与标准CR相比,用SMT增强的CR显著降低了压力和改善了医疗结果.
- 在整体CR中集成时,SMT提供了增量效益.
- 应定期将SMT纳入心脏康复计划中.
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