D型与非D型人格冠心病患者的健康赋权、感知控制和经验性回避特征比较

doi:10.3969/j.issn.1006-9771.2024.05.011

《中国康复理论与实践》 ›› 2024, Vol. 30 ›› Issue (5): 570-576.doi: 10.3969/j.issn.1006-9771.2024.05.011

D型与非D型人格冠心病患者的健康赋权、感知控制和经验性回避特征比较

张睿琳¹, 张秋敏¹, 王丽娟², 齐万鹏², 宋玉萍¹, 姜能志¹, 田相娟¹()

1.山东第二医科大学心理学院，山东潍坊市 261053
2.山东第二医科大学附属医院，山东潍坊市 261031

收稿日期:2024-04-19 出版日期:2024-05-25 发布日期:2024-06-12
通讯作者: 田相娟(1990-)，女，汉族，山东临沂市人，博士，讲师，主要研究方向：临床心理学。田相娟，E-mail： xiangjuanti@126.com
作者简介:张睿琳(1998-)，女，汉族，山东烟台市人，硕士研究生，主要研究方向：临床心理学。
基金资助:
1.山东省自然科学基金面上项目(ZR2021MC037);2.潍坊市科技发展计划(软科学)项目(2023RKX134);3.山东省教育发展研究微课题(FH032)

Characteristics of health empowerment, perceived control and experiential avoidance in coronary heart disease patients with type D and non-type D personality

ZHANG Ruilin¹, ZHANG Qiumin¹, WANG Lijuan², QI Wanpeng², SONG Yuping¹, JIANG Nengzhi¹, TIAN Xiangjuan¹()

1. School of Psychology, Shandong Second Medical University, Weifang, Shandong 261053, China
2. Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong 261031, China

Received:2024-04-19 Published:2024-05-25 Online:2024-06-12
Contact: TIAN Xiangjuan, E-mail: xiangjuanti@126.com
Supported by:
Natural Science Foundation of Shandong (General)(ZR2021MC037);Science and Technology Development Program (Soft Science) Project of Weifang City(2023RKX134);Educational Development Research Micro-project of Shandong(FH032)

摘要/Abstract

摘要：

目的探讨D型与非D型人格冠心病患者健康赋权、感知控制和经验性回避的差异。

方法 2022年1月至10月，方便选取山东第二医科大学附属医院195例冠心病患者。采用D型人格量表、中文版赋权感知量表(CV-PPES)、修订版控制态度量表(CAS-R)和接纳与行动问卷第二版(AAQ-II)对患者进行问卷调查。

结果共回收有效问卷185份，其中D型人格患者68例，非D型117例。与非D型患者相比，D型患者的消极情感与社交抑制得分均显著较高(|t| > 9.783, P < 0.001)。D型患者在CV-PPES总分及信息、决策、个体化和自我管理4个维度分均显著低于非D型患者(t > 5.843, P < 0.001)。D型患者CAS-R评分明显低于非D型患者(t = 2.858, P = 0.005)，AAQ-II评分显著高于非D型患者(t = -9.414, P < 0.001)。

结论与非D型人格比较，D型人格冠心病患者的健康赋权和感知控制水平较低，而经验性回避水平较高，可能会对健康行为产生消极影响。

关键词: 冠心病, D型人格, 健康赋权, 感知控制, 经验性回避

Abstract:

Objective To investigate the differences in health empowerment, perceived control and experiential avoidance between patients with coronary heart disease (CHD) with type D personality and non-type D personality.

Methods From January to October, 2022, using the convenient sampling method, a questionnaire survey was conducted on 195 patients with CHD from Affiliated Hospital of Shandong Second Medical University. Assessment tools included Type D Personality Scale, Chinese Version of Patient Perception Empowerment Scale (CV-PPES), Control Attitudes Scale-Revised (CAS-R) and Acceptance Action Questionnaire-II (AAQ-II).

Results A total of 185 effective questionnaires were returned, and 68 patients with type D personality. Compared with the patients with non-type D personality, the scores of negative affectivity and social inhibition were higher (|t| > 9.783, P < 0.001), the total score of CV-PPES and the scores of four dimensions (information, decision, individual and self-management) were lower (t > 5.843, P < 0.001), the score of CAS-R was lower (t = 2.858, P= 0.005), and the score of AAQ-II was higher (t = -9.414, P < 0.001) in CHD patients with type D personality.

Conclusion Compared with non-D-type patients, CHD patients with D-type personality exhibit lower levels of health empowerment and perceived control, and higher level of experiential avoidance, which may negatively impact on health behaviors.

Key words: coronary heart disease, type D personality, health empowerment, perceived control, experiential avoidance

中图分类号:

R541.4

张睿琳, 张秋敏, 王丽娟, 齐万鹏, 宋玉萍, 姜能志, 田相娟. D型与非D型人格冠心病患者的健康赋权、感知控制和经验性回避特征比较[J]. 《中国康复理论与实践》, 2024, 30(5): 570-576.

ZHANG Ruilin, ZHANG Qiumin, WANG Lijuan, QI Wanpeng, SONG Yuping, JIANG Nengzhi, TIAN Xiangjuan. Characteristics of health empowerment, perceived control and experiential avoidance in coronary heart disease patients with type D and non-type D personality[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(5): 570-576.

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参考文献 51

[1]	«中国心血管健康与疾病报告2022»编写组. «中国心血管健康与疾病报告2022»要点解读[J]. 中国心血管杂志, 2023, 28(4): 297-312.
	The Writing Committee of the Report on Cardiovascular Health Diseases in China. Interpretation of Report on Cardiovascular Health and Diseases in China 2022[J]. Chin J Cardiol, 2023, 28(4): 297-312.
[2]	RAO S V, REYNOLDS H R, HOCHMAN J S. Chronic coronary disease guidelines[J]. Circulation, 2023, 148(9): 729-731. doi: 10.1161/CIRCULATIONAHA.123.064623 pmid: 37471475
[3]	REN Y, TANG H, ZHANG L, et al. Exploration of therapeutic models for psycho-cardiology: from cardiac to psychological rehabilitation[J]. Heliyon, 2024, 10(6): e27484.
[4]	KUPPER N, DENOLLET J. Type D personality as a risk factor in coronary heart disease: a review of current evidence[J]. Curr Cardiol Rep, 2018, 20(11): 104. doi: 10.1007/s11886-018-1048-x pmid: 30209683
[5]	CONTI C, CARROZZINO D, PATIERNO C, et al. The clinical link between type D personality and diabetes[J]. Front Psychiatry, 2016, 7: 113. doi: 10.3389/fpsyt.2016.00113 pmid: 27445869
[6]	LIN T K, YOU K X, HSU C T, et al. Negative affectivity and social inhibition are associated with increased cardiac readmission in patients with heart failure: a preliminary observation study.[J]. PLoS One, 2019, 14(4): e0215726.
[7]	WANG Y, LIU G, GAO X, et al. Prognostic value of type D personality for in-stent restenosis in coronary artery disease patients treated with drug-eluting stent[J]. Psychosom Med, 2018, 80(1): 95-102. doi: 10.1097/PSY.0000000000000532 pmid: 28938244
[8]	KUPPER N, DENOLLET J. Type D personality as a prognostic factor in heart disease: assessment and mediating mechanisms[J]. J Pers Assess, 2007, 89(3): 265-276. doi: 10.1080/00223890701629797 pmid: 18001227
[9]	YI H, LI L, WANG Y, et al. The potential mediating effects of inflammation on the association between type d personality and coronary plaque vulnerability in patients with coronary artery disease: an optical coherence tomography study[J]. Psychosom Med, 2022, 84(4): 468-477. doi: 10.1097/PSY.0000000000001068 pmid: 35311805
[10]	VAINAUSKIENE V, VAITKIENE R. Enablers of patient knowledge empowerment for self-management of chronic disease: an integrative review[J]. Int J Environ Res Public Health, 2021, 18(5): 2247.
[11]	RAINA R S, THAWANI V. The zest for patient empowerment[J]. J Clin Diagn Res, 2016, 10(6): FE01-FE03.
[12]	WAHLIN I. Empowerment in critical care: a concept analysis[J]. Scand J Caring Sci, 2017, 31(1): 164-174.
[13]	刘佳欣, 吴樱, 彭丽霞, 等. 健康赋权在养老机构老年人创伤后成长和慢性病自我管理的中介作用[J]. 现代预防医学, 2022, 49(12): 2228-2234, 2261.
	LIU J X, WU Y, PENG L X, et al. The mediating role of health empowerment in post-traumatic growth and chronic disease self-management among elderly people in nursing institutions[J]. Mod Prev Med, 2022, 49(12): 2228-2234, 2261.
[14]	YEH M Y, LIN S H, TUNG T H. Psychometric evaluation of the Chinese version of the Patient Perceptions of Empowerment Scale (PPES)[J]. Biomed Res Int, 2014, 2014: 867451.
[15]	KUCHI Z G, MATOURYPOUR P, ESMAEILI M, et al. Effect of an empowerment program on life orientation and optimism in coronary artery disease patients[J]. Iran J Nurs Midwifery Res, 2023, 28(1): 32-37. doi: 10.4103/ijnmr.ijnmr_5_21 pmid: 37250938
[16]	KUCHI Z G, ZAKERIMOGHADAM M, ESMAEILI M, et al. The effect of an empowerment program on the perceived risk and physical health of patients with coronary artery disease[J]. Holist Nurs Pract, 2020, 34(3): 163-170. doi: 10.1097/HNP.0000000000000370 pmid: 32282492
[17]	KIM J, SHIN N. Concept analysis of the empowerment of patients with coronary artery disease using a hybrid model[J]. ANS Adv Nurs Sci, 2022, 45(1): E31-E46.
[18]	ANDREAE C, TINGSTROM P, NILSSON S, et al. Does problem-based learning improve patient empowerment and cardiac risk factors in patients with coronary heart disease in a Swedish primary care setting? A long-term prospective, randomised, parallel single randomised trial (COR-PRIM)[J]. BMJ Open, 2023, 13(2): e065230.
[19]	王祚传, 李中清, 宋江艳, 等. 老年冠心病PCI术后患者目标承诺、应对方式在家庭功能与感知控制间的中介作用[J]. 中华疾病控制杂志, 2021, 25(12): 1476-1480.
	WANG Z C, LI Z Q, SONG J Y, et al. Analysis of the mediating effect of goal commitment and coping style between family function and perceived control in elderly patients with coronary heart disease after PCI[J]. Chin J Dis Control Prev, 2021, 25(12): 1476-1480.
[20]	VARGAS E A, CHIRINOS D A, MAHALINGAM R, et al. Discrimination, perceived control, and psychological health among African Americans with hypertension[J]. J Health Psychol, 2021, 26(14): 2841-2850.
[21]	LY V, WANG K S, BHANJI J, et al. A reward-based framework of perceived control[J]. Front Neurosci, 2019, 13: 65.
[22]	ZHAO T, FU Z, LIAN X, et al. Exploring emotion regulation and perceived control as antecedents of anxiety and its consequences during Covid-19 full remote learning[J]. Front Psychol, 2021, 12: 675910.
[23]	LIN C Y, MILLER J L, LENNIE T A, et al. Perceived control predicts symptom status in patients with heart failure[J]. J Cardiovasc Nurs, 2020, 35(6): 530-537.
[24]	DOERING L V, CHEN B, DENG M, et al. Perceived control and health-related quality of life in heart transplant recipients[J]. Eur J Cardiovasc Nurs, 2018, 17(6): 513-520.
[25]	KONDO A, OKI T, OTAKI A, et al. Relationship between resilience and perceived control after acute coronary syndrome: a prospective study[J]. J Cardiovasc Nurs, 2023, 38(1): E20-E30.
[26]	ABURUZ M E. Perceived control moderates the relationship between anxiety and in-hospital complications after ST segment elevation myocardial infarction[J]. J Multidiscip Healthc, 2018, 11: 359-365. doi: 10.2147/JMDH.S170326 pmid: 30100731
[27]	MCKINLEY S, FIEN M, RIEGEL B, et al. Complications after acute coronary syndrome are reduced by perceived control of cardiac illness[J]. J Adv Nurs, 2012, 68(10): 2320-2330. doi: 10.1111/j.1365-2648.2011.05933.x pmid: 22235775
[28]	LUOMA J B, PIERCE B, LEVIN M E. Experiential avoidance and negative affect as predictors of daily drinking[J]. Psychol Addict Behav, 2020, 34(3): 421-433. doi: 10.1037/adb0000554 pmid: 31999171
[29]	ROCHEFORT C, BALDWIN A S, CHMIELEWSKI M. Experiential avoidance: an examination of the construct validity of the AAQ-II and MEAQ[J]. Behav Ther, 2018, 49(3): 435-449. doi: S0005-7894(17)30095-3 pmid: 29704971
[30]	CELANO C M, MILLSTEIN R A, BEDOYA C A, et al. Association between anxiety and mortality in patients with coronary artery disease: a meta-analysis[J]. Am Heart J, 2015, 170(6): 1105-1115. doi: 10.1016/j.ahj.2015.09.013 pmid: 26678632
[31]	PALANDACIC A K, RADEZ J, UCMAN S, et al. Evaluating anxiety in elective coronary angiography study: rationale, design, and study methodology[J]. J Cardiovasc Med (Hagerstown), 2022, 23(10): 678-684. doi: 10.2459/JCM.0000000000001355 pmid: 36099075
[32]	BARDEEN J R. Short-term pain for long-term gain: the role of experiential avoidance in the relation between anxiety sensitivity and emotional distress[J]. J Anxiety Disord, 2015, 30: 113-119. doi: 10.1016/j.janxdis.2014.12.013 pmid: 25723652
[33]	DAVIS S, SERFATY M, LOW J, et al. Experiential avoidance in advanced cancer: a mixed-methods systematic review[J]. Int J Behav Med, 2023, 30(5): 585-604.
[34]	邱卓英, 李伦, 陈迪, 等. 基于世界卫生组织国际健康分类家族康复指南研究:理论架构和方法体系[J]. 中国康复理论与实践, 2020, 26(2): 125-135. doi: 10.3969/j.issn.1006-9771.2020.02.001
	Q1U Z Y, LI L, CHEN D, et al. Research on rehabilitation guidelines using World Health Organization Family of international Classifications: framework and approaches[J]. Chin J Rehabil Theory Pract, 2020, 26(2): 125-135.
[35]	FAN Y H, LIOU Y J, CHENG W M. Type D Personality independently predicts erectile dysfunction in Taiwanese young men[J]. J Sex Med, 2022, 19(9): 1397-1403.
[36]	CAO Y, LIU Q, YU Q, et al. Depression mediates the relationship of experiential avoidance and internet addiction: a cross-lagged mediation analysis[J]. [ahead of print] Curr Psychol, 2023. doi: 10.1007/s12144-023-04511-6.
[37]	MANOJ M T, JOSEPH K A, VIJAYARAGHAVAN G. Type D personality and myocardial infarction: a case-control study[J]. Indian J Psychol Med, 2020, 42(6): 555-559. doi: 10.1177/0253717620941157 pmid: 33354082
[38]	VUKOVIC O, TOSEVSKI D L, JASOVIC-GASIC M, et al. Type D personality in patients with coronary artery disease[J]. Psychiatr Danub, 2014, 26(1): 46-51. pmid: 24608156
[39]	LEU H B, YIN W H, TSENG W K, et al. Impact of type D personality on clinical outcomes in Asian patients with stable coronary artery disease[J]. Formos Med Assoc, 2019, 118(3): 721-729.
[40]	WANG Y, ZHANG S, ZHANG G, et al. Association between type D personality and in-stent restenosis in patients treated with percutaneous coronary intervention: a mediation analysis of dietary patterns[J]. J Psychosom Res, 2020, 138: 110244.
[41]	PUSHKAREV G S, KUZNETSOV V A, FISHER Y A. Type D personality in patients with coronary heart disease underwent coronary stenting: a prospective study[J]. Kardiologiia, 2019, 59(12S): 18-24.
[42]	CHENG F, LIN P, WANG Y, et al. Type D personality and coronary atherosclerotic plaque vulnerability: the potential mediating effect of health behavior[J]. J Psychosom Res, 2018, 108: 54-60. doi: S0022-3999(17)31073-5 pmid: 29602326
[43]	TORGERSEN K S, SVERRE E C B, WEEDON-FEKJAER H, et al. Risk of recurrent cardiovascular events in coronary artery disease patients with type D personality[J]. Front Psychol, 2023, 14: 1119146.
[44]	AL-QEZWENY M N, UTENS E M, DULFER K, et al. The association between type D personality, and depression and anxiety ten years after PCI[J]. Neth Heart J, 2016, 24(9): 538-543.
[45]	SENNWALD V, POOL E, BROSCH T, et al. Emotional attention for erotic stimuli: cognitive and brain mechanisms[J]. J Comp Neurol, 2016, 524(8): 1668-1675. doi: 10.1002/cne.23859 pmid: 26179894
[46]	RAYKH O I, SUMIN A N, KOROK E V. The influence of personality type D on cardiovascular prognosis in patients after coronary artery bypass grafting: data from a 5-year-follow-up study[J]. Int J Behav Med, 2022, 29(1): 46-56.
[47]	HABIBOVIC M, GAVIDIA G, BROERS E, et al. Type D personality and global positioning system tracked social behavior in patients with cardiovascular disease[J]. Health Psychol, 2020, 39(8): 711-720. doi: 10.1037/hea0000823 pmid: 32297772
[48]	WU J R, SONG E K, MOSER D K. Type D personality, self-efficacy, and medication adherence in patients with heart failure: a mediation analysis[J]. Heart Lung, 2015, 44(4): 276-281.
[49]	SONG Y Y, CHEN L, WANG W X, et al. Social support, sense of coherence, and self-management among hemodialysis patients[J]. West J Nurs Res, 2022, 44(4): 367-374.
[50]	DUIJNDAM S, DENOLLET J. Social inhibition in population-based and cardiac patient samples: robustness of inhibition, sensitivity and withdrawal as distinct facets[J]. Gen Hosp Psychiatry, 2019, 58: 13-23.
[51]	A-TJAK J G, DAVIS M L, MORINA N, et al. A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems[J]. Psychother Psychosom, 2015, 84(1): 30-36. doi: 10.1159/000365764 pmid: 25547522

项目	D型人格 (n = 68)	非D型人格(n = 117)	t值	P值
消极情感	12.529±2.588	8.667±2.590	-9.783	< 0.001
社交抑制	12.294±2.247	8.299±2.669	-10.385	< 0.001

项目		D型人格(n = 68)	非D型人格(n = 117)	χ²值	P值
性别	男	41	73	0.080	0.777
性别	女	27	44	0.080	0.777
年龄	< 60岁	24	54	2.080	0.149
年龄	> 60岁	44	63	2.080	0.149
文化程度	初中及以下	41	76	0.402	0.526
文化程度	高中及以上	27	41	0.402	0.526
吸烟史	无吸烟史	38	58	0.686	0.408
吸烟史	有吸烟史	30	59	0.686	0.408
饮酒史	无饮酒史	31	53	0.001	0.970
饮酒史	有饮酒史	37	64	0.001	0.970

项目	D型人格 (n = 68)	非D型人格 (n = 117)	t值	P值
CV-PPES总分	38.824±3.081	43.957±4.557	8.254	< 0.001
信息	10.691±1.175	11.846±1.264	6.148	< 0.001
决策	6.647±0.958	7.786±1.431	5.843	< 0.001
个体化	10.353±1.255	11.957±1.626	7.009	< 0.001
自我管理	11.132±1.171	12.368±1.495	5.849	< 0.001
CAS-R评分	24.603±3.971	26.667±5.126	2.858	0.005
AAQ-II评分	26.588±5.453	18.932±5.263	-9.414	< 0.001

D型与非D型人格冠心病患者的健康赋权、感知控制和经验性回避特征比较

Characteristics of health empowerment, perceived control and experiential avoidance in coronary heart disease patients with type D and non-type D personality

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