中青年男性冠心病PCI术后患者及其配偶二元应对对生活质量的影响

目的　了解中青年男性冠心病经皮冠状动脉介入术（PCI）术后患者及其配偶的二元应对、生活质量现状,探讨患者及配偶二元应对方式对双方生活质量的影响,为临床制订夫妻共同应对冠心病的干预措施提供依据。方法　采用便利抽样法,选取2020年1月1日至2021年1月31日在南阳医学高等专科学校第一附属医院及南阳市第六人民医院门诊复查的中青年男性冠心病PCI术后患者及其配偶共220对为研究对象。入组患者年龄18～59岁,均符合已婚且与配偶共同生活等纳入条件。配偶纳入标准主要为患者的主要照顾者,近期6个月内未发生创伤性事件等。采用一般资料调查表、二元应对问卷、简明健康状况调查问卷进行调查。采用描述性统计、χ²检验、t检验、Pearson相关分析数据。建立主-客体互倚模型,通过Bootstrap法分析变量间的主客体效应。结果　患者二元应对总分为（104.06±8.34）分,配偶二元应对总分为（104.13±7.80）分,差异无统计学意义（P>0.05）。患者与配偶的生活质量总分比较,差异无统计学意义（P>0.05）。Pearson相关分析表明,患者与其配偶的二元应对总分呈正相关（r=0.326,P<0.001）;患者与其配偶的生活质量总分呈正相关（r=0.357,P<0.001）。患者二元应对总分与自身、配偶生活质量总分呈正相关（r=0.570、0.465,均P<0.05）;配偶二元应对总分与自身、患者生活质量总分呈正相关（r=0.601、0.348,均P<0.05）。主客体互倚模型结果表明,患者及配偶的二元应对均对其自身生活质量有正向预测作用（β=0.623、0.710,P<0.05）。患者的积极二元应对对配偶生活质量有正向影响（β=0.342,P<0.05）,配偶的积极二元应对对患者生活质量有正向影响（β=0.431,P<0.05）。结论　中青年男性冠心病PCI术后患者及其配偶的二元应对和生活质量水平均有待提高。建议将配偶纳入到疾病管理中,围绕夫妻为中心制定针对性二元应对干预方案,从而有效提高患者、配偶以及整个家庭的健康和生活质量。

Influence of binary coping between young and middle-aged male patientswith coronary heart disease and their spouses on quality of life after PCI

Objective　To investigate the status quo of binary coping and quality of life ofmiddle-aged and young male patients with coronary heart disease after PCI andtheir spouses, to explore the impact of binary coping style of patients andtheir spouses on the quality of life of both parties, and to provide a basisfor clinical intervention measures for couples to cope with coronary heartdisease. Methods　The conveniencesampling method was used to select 220 pairs of middle-aged and young malepatients with coronary heart disease after PCI and their spouses from The FirstAffiliated Hospital of Nanyang Medical College and No. 6 People's Hospital ofNanyang City from January 1, 2020 to January 31, 2021. The patients were 18 to59 years old, and all met the inclusion criteria such as being married andliving with their spouses. The main inclusion criteria for the spouses were thepatients' primary caregivers, and no traumatic events had occurred in recent 6months. The General Data Questionnaire, Binary Response Questionnaire, andBrief Health Status Questionnaire were used for investigation. Descriptivestatistics, χ² test, t test, and Pearson correlation wereused to analyze the data. The host-object interaction model was established,and the host-object effect between variables was analyzed by the Bootstrapmethod. Results　The total binarycoping score of the patients was (104.06±8.34), and that of their spouses was(104.13±7.80), with no statistical difference (P>0.05). There was no statistical difference in the total scoreof quality of life between the patients and their spouses (P>0.05). Pearson correlation analysis showed that there was apositive correlation between the patients' and their spouses' total scores ofbinary coping (r=0.326, P< 0.001). The total scores ofquality of life of the patients and their spouses was positively correlated (r=0.357, P<0.001). The patients' binary coping scores positivelycorrelated with their and their spouses' total scores of quality of life (r=0.570 and 0.465, both P<0.05). The spouses' binary copingscore positively correlated with their and the patients' total scores ofquality of life (r=0.601 and 0.348,both P<0.05). The results of thehost-object interaction model showed that the binary coping of the patients andtheir spouses positively predicted their own quality of life (β=0.623 and 0.710, P<0.05). The patients' positive binary coping had a positiveimpact on their spouses ' quality of life (β=0.342, P<0.05), and spouses' positivebinary coping had a positive impact on the patients' quality of life (β=0.431, P<0.05). Conclusions　The binary coping andquality of life of middle-aged and young male patients with coronary heartdisease after PCI and their spouses need to be improved. It is suggested thattheir spouses should be included in disease management and targeted binary interventionprograms should be developed around the couples to effectively improve thehealth and quality of life of patients, spouses, and the whole families.