曹二凤，王宇涛，李鹏，段凯星，葛文嘉，王洁

引用本文： 曹二凤，王宇涛，李鹏，段凯星，葛文嘉，王洁.急性心肌梗死PCI术后病人急性应激障碍现状及其与疾病感知和应对方式的相关性[J].护理研究,2024,38(1):37-42

摘要： 目的： 调查急性心肌梗死冠状动脉介入（PCI）术后病人急性应激障碍的现状，并探讨其与疾病感知和应对方式的相关性。 方法： 便利选取2023年1月—4月山西省某三级甲等医院205例急性ST段抬高型PCI术后病人，采用一般资料调查表、简易疾病感知问卷、医学应对方式问卷、斯坦福急性应激反应问卷进行调查。 结果： PCI术后病人急性应激障碍总分为（42.60±10.22）分。回归分析结果显示，性别、疼痛等级、疾病感知和面对是急性应激障碍的影响因素。中介效应分析结果显示，疾病感知可直接预测急性应激障碍（=0.21，=0.002），面对在疾病感知和急性应激障碍间起中介作用（=0.05，<0.05），中介效应占总效应的19.23%。 结论： 急性心肌梗死PCI术后病人急性应激障碍水平较高，医护人员应关注女性、疼痛程度高的病人，通过制定个性化的健康教育降低疾病感知并采用积极应对，以减少急性应激障碍的发生。

关键词： 急性心肌梗死;疾病感知;应对方式;急性应激障碍;中介效应

课题： 2022年度山西白求恩医院院级护理科研基金项目(2022YH05)

CAO Erfeng，WANG Yutao，LI Peng，DUAN Kaixing，GE Wenjia，WANG Jie

Abstract Objective： To investigate the current status of acute stress disorder in patients with acute myocardial infarction after PCI and to explore its correlation with disease perception and coping mode. Methods： A convenient sample of 205 patients with acute ST⁃segment elevation PCI from January to April 2023 in a tertiary grade A hospital in Shanxi was investigated by general data questionnaire， Stanford Acute Stress Reaction Questionnaire，Medical Coping Modes Questionnaire，Brief Illness Perception Questionnaire. Results： The total score of acute stress disorder of 205 patients with acute ST⁃segment elevation PCI was （42.60±10.22）.The results of regression analysis showed that gender，pain level， disease perception and exposure were the influencing factors of acute stress disorder.Mediation effect analysis showed that disease perception could directly predict acute stress disorder （=0.21，=0.002）.Facing played a mediating role between illness perception and acute stress disorder （=0.05，<0.05），and the mediating effect accounted for 19.23% of the total effect. Conclusion： Patients with acute myocardial infarction after PCI have a high level of acute stress disorder，and medical staff should pay attention to women and patients with high pain level， reduce disease perception and adopt positive response through personalized education to reduce the occurrence of acute stress disorder.

Keywords acute myocardial infarction;disease perception;coping strategies;acute stress disorder;mediation effect

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