急性心肌梗死患者压力感受及压力反应的纵向研究
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摘要
背景：急性心肌梗死(AMI)作为冠心病中的严重类型,已经对我国人民的健康构成了严重威胁。近年来我国急性心肌梗死的发病率正逐渐升高。由于AMI起病急、急性期病情重、变化快,且患者出院后原有的生活状态面临较大改变,在面对与疾病、医院环境及家庭社会等方面的压力源时,患者会有不同的压力感受。既往研究显示AMI患者在康复过程中存在不同程度的心理压力。目前国内还未见深入探讨AMI患者患病后压力感受和压力反应的质性研究和纵向研究。本研究运用“压力认知交互作用理论”作为理论框架,强调了应对方式和社会支持在心理应激中的调节作用,采用深入访谈和量性测评相结合的方法,对AMI患者康复过程中的压力感受及压力反应进行纵向研究。
目的：(1)探讨AMI患者康复过程中不同时期的压力感受程度及其变化情况；(2)探讨AMI患者康复过程中不同时期的压力反应及其变化情况；(3)描述AMI患者康复过程中不同时期的应对方式及社会支持状况；(3)分析AMI患者康复过程中不同时期压力感受及压力反应的影响因素；(4)探索AMI患者康复过程中的压力体验。
方法：本研究包括两部分,即量性研究中的纵向调查研究和质性研究中的现象学研究。
在量性研究部分,本研究以方便抽样的方法,从2010年1月至9月,从上海市中山医院和华山医院的心内科CCU病房中,抽取符合纳入标准的AMI患者60名进行为期6个月的随访调查。采用一般资料调查表、中文版压力知觉量表(CPSS)、综合医院焦虑抑郁量表(HADS)、医学应对问卷(MCMQ)和社会支持评定量表(SSS)来评价AMI患者的一般人口社会学资料、压力感受、心理压力反应、应对方式和社会支持情况。研究分别在患者患病后7-10天、6周、3个月及6个月时发放问卷。所得数据采用SPSS15.0进行统计分析。
在质性研究部分,采用质性研究中的现象学研究方法,对15名急性心肌梗死患者在其患病后7-10天、6周、3个月及6个月分别进行深度访谈,并采用现象学分析法分析资料。
结果：量性研究：(1)AMI患者四个时间点的CPSS的得分为19.45±5.96、17.67±6.33、14.75±6.41、15.25±6.32,经过重复测量的方差分析,不同时间AMI患者的CPSS得分之间差异有统计学意义(P<0.05)。AMI患者四个时间点的健康危险性压力的发生率分别为20%、15%、8.3%、8.3%,且经卡方检验不同时间的健康危险性压力的发生率之间差异有统计学意义(P<0.05)。(2)四个时间AMI患者的焦虑得分分别为6.80±2.57、5.88±2.15、5.08±2.55及4.82±2.49,经重复测量的方差分析,不同时间患者的焦虑得分之间差异有统计学意义(P<0.05)。四个时间点AMI患者的抑郁得分分别为5.52±3.66、4.67±3.81、4.23±3.55、4.03±2.86,且不同时间的抑郁得分之间差异有统计学意义(P<0.05)。四个时间点AMI患者的焦虑阳性率为33.3%、20%、10%、11.7%,且焦虑阳性率之间差异有统计学意义(P<0.05)。四个时间点患者抑郁阳性率为33.3%、20%、23.3%、11.3%,且差异有统计学意义(P<0.05)。(3)将AMI患者四个时间点的三种应对方式得分分别与常模比较,除6周时面对得分与常模相比差异不显著,其余时间的面对得分均低于常模,且差异有统计学意义(P<0.05)；除6个月时回避得分与常模相比差异不显著,其余时间的回避得分均高于常模,且差异有统计学意义；仅在住院阶段患者的屈服应对得分高于常模,差异有统计学意义(P<0.05)。重复测量的方差分析示,不同时间AMI患者的面对和回避得分之间差异不显著,不同时间患者的屈服应对得分之间差异有统计学意义(P<0.05)。(4)四个时间点AMI患者的社会支持总分均高于常模(P<0.05),四个时间点AMI患者的主观支持、客观支持、对支持的利用度及社会支持总分之间差异无统计学意义(P>0.05)。(5)AMI患者患病后7-10天时,屈服应对、吸烟史、面对应对、职业和居住状态是患者压力感受的影响因素；心功能分级是患者焦虑反应的影响因素；社会支持总分和屈服应对是患者抑郁反应的影响因素。患者患病后6周时,屈服应对、锻炼习惯、年龄和社会支持总分是压力感受的影响因素；屈服应对、年龄和锻炼习惯是患者焦虑反应的影响因素；屈服应对、面对应对、锻炼习惯和年龄是患者抑郁反应的影响因素。患者患病后3个月时,屈服应对是压力感受、焦虑抑郁反应的影响因素；客观支持、职业和回避应对是患者抑郁反应的影响因素。患者患病后6个月时,屈服应对、锻炼习惯、心功能分级是压力感受的影响因素；屈服应对、锻炼习惯和客观支持是焦虑反应的影响因素；屈服应对和回避应对是患者抑郁反应的影响因素。
质性研究：将AMI患者急性期的压力反应归纳为三个方面：①面对现实的打击；②适应角色改变；③准备回归与重建。将AMI患者出院后6个月内的压力反应归纳为三个方面：①关注疾病康复；②生活习惯的改变；③人际关系的重建。结论(1)AMI患者住院时的压力感受程度最重,患者的压力感受在出院后前3个月下降显著,但是仍有一定程度的压力,3个月后压力感受下降不明显。(2)在住院阶段AMI患者在面对现实打击、适应角色改变及准备回归与重建的过程中出现了压力反应。出院后AMI患者由于关注疾病康复、生活习惯的改变和人际关系的重建而出现了不同的心理压力反应。(3)AMI患者较倾向于采用回避方式应对,较少采用面对方式。(4)不同应对方式在患者患病后的不同阶段有不同的影响。(5)社会支持在AMI患者患病过程中有助于减少心理压力。(6)良好的生活习惯有助于减少患者心理压力。(7)能否重返工作是AMI患者患病过程关注的问题。
Background:Acute myocardial infarction(AMI) is a serious coronary heart disease, and it has posed a health threat to people in our country. The incidence of AMI in china has been increasing these years. The onset of AMI is usually unexpected, and at the acute phase, the patients are in a very serious condition and the illness condition changes quickly. After discharging from the hospital, the patients' lifestyle and living conditions may experience significant changes. When facing with the stressors coming from the disease,environment of the hospital, or the family and society, the patients may have different stress perceptions. Some studys showed that patients with AMI had various digrees of pressure during the rehabilitation process.In our country, there are no study investigating the change of the patients'stress perception and stress response longitudinally. This study used the theory-"interaction of cognitive and stress" as the framework, and especially considered the regulating function of coping styles and social support on patients'psychological health, conducted a longitudinal study using the qulitative method combined with the quantitative evaluation to explore the stress perception and stress response of patients with AMI.
Objective:(1) To investigate the level of stress perception and its the changing trend in patients with acute myocardial infarction (AMI) during their rehabilitation process;(2)To investigate the stress response status and its changing trend in patients with AMI during their rehabilitation process;(3) To identify the coping style and the social support in patients with AMI in four periods; (4) To analyze the influential factors of stress perception and stress response status of patients with AMI in four periods during their rehabilitation process; (5) To explore the stress experiences of patients with AMI during the first 6 months after the onset of the disease.
Methods:This study includes two parts:the Longitudinal survey and the qualitative study using the phenomenology method.
In the Longitudinal survey study,60 AMI patients from the cardiology department of Zhongshan hospital and Huashan hospital, were investigated during the first 6 months in their rehabilitation process from January 2010 to September 2010. The Common status Questionnaire, The Chinese Perceived Stress Scale(CPSS),The Hospital Anxiety and Depression Scale(HADS), the Social Support Scale(SSS) and the Medical Coping Modes Questionnaire(MCMQ) were used respectively to investigate the common status, stress perception, psychological stress responses, social support conditions and coping styles of patients with AMI. The survey were conducted in four different times:7～10 days (time 1)、6 weeks (time 2)、3 months (time 3) and 6 months (time 4) after the onset of AMI. The SPSS15.0 was used for data analysis.
In the qualitative study, the phenomenology method was adopted,15 patients with AMI participated in the semi-structure interviews which were conducted in four times:7～10 days, six weeks, three months and six months after the discharge. The data was analyzed by Claizzi's phenomenological procedure.
Results:In the Longitudinal survey study:(1) The scores of CPSS scale in four times were 19.45±5.96、17.67±6.33、14.75±6.41、15.25±6.32, The repeated measure analysis of variance indicated that the level of stress perceptions were different along with the change of time (P< 0.05).The percentages of patients with stress threating to health in the four times were:20%、15%、8.3%、8.3%. The chi-square test indicated that the difference between these four percentages was significant (P <0.05). (2)The scores of anxiety in the four times were:6.80±2.57、5.88±2.15、5.08±2.55及4.82±2.49. The repeated measure analysis of variance indicated that there were significant difference between the scores of anxiety in four time points (P<0.05). The scores of depression in the four times were:5.52±3.66、4.67±3.81、4.23±3.55、4.03±2.86. The repeated measure analysis of variance indicated that there were significant difference between the scores of anxiety in four time points(P<0.05). The incidence of anxiety in the four times were:33.3%、20%、10%、11.7%, which were significantly different (P<0.05). The incidence of depression in the four times were:33.3%、20%、23.3%、11.3%, which had significant difference (P<0.05). (3) Comparing the average scores of the confrontation coping style to the norm, except the scores measured in the 6th week, the other scores were significantly lower than the norm(P<0.05). Comparing the average scores of the avoidance coping style to the norm, except the scores measured in the 6th month, the other scores were significantly higher than the norm(P<0.05). Comparing the average scores of the resignation coping style to the norm, only the score of resignation coping style measured in hospital was significantly higher than the common model (P<0.05). The repeated measure analysis of variance showed that:At different time points, the difference of the scores of confrontation coping style had no statistics significance(P >0.05), and the difference of the scores of avoidance coping style had no statistics significance(P> 0.05), but the scores of resignation coping style significance were significant different (P<0.05). (4) The whole social support scores in four time points were all higher than the common model (P<0.05). The scores of active support, objective support, utilization of support and the whole score of support had no significant change along with time(P>0.05). (5) The stepwise regression analysis showed that:during 7～10 days after the onset of AMI, the level of stress perception was influenced by resignation coping, smoking state in the past, confrontation coping, occupation and living status;the level of cardiac function may influence the incidence of anxiety; the whole score of social support and the resignation coping might influence the incidence of depression. On the time of six weeks after the onset of AMI, the level of stress perception was influenced by resignation coping,exercising status in the past, age and the whole score of social support;the resignation coping, age and exercising status in the past might influence the incidence of anxiety; the resignation coping, age, exercising status in the past and confrontation coping might influence the incidence of depression. On the time of three months after the onset of AMI, the level of stress perception and the incidence of anxiety and depression were influenced by resignation coping;the passive support, occupation and avoidance coping may influence the incidence of depression. On the time of six months after the onset of AMI, the level of stress perception was influenced by resignation coping, exercising status and the level of cardiac function;the resignation coping, exercising status and passive support might influence the incidence of anxiety; the resignation coping and the avoidance coping mmight influence the incidence of depression.
In the qualitative study:the stress response of patients at the early stage of AMI included three aspects:①facing the strike of reality;②the changing role;③preparation of going back to normal life and rebuilding. The stress response of patients with AMI when they leave hospital included three aspects:①worrying about the rehabilitation of
AMI;②changing the living habits;③rebuilding the interpersonal relationships.
Conclusions:(1) The stress perception was most significant when patients were in hospital, although the level of stress perception decreased after they discharged, patients still had some stress in life. (2) According to the semi-structure interviews, patients in hospital felt stressful during the process of facing the strike of reality, changing the role and preparing for going back to normal life and rebuilding. When patients left hospital after they discharged, they felt stressful during the process of worrying about the rehabilitation, changing the living habits and rebuilding the interpersonal relationships. (3)The patients with AMI preferred to use the avoidance coping style during the rehabilitation process, and they used the confrontation coping style less frequently than the norm. (4) AMI patients should choose different coping strategies according to different phases during the disease rehabilitation. (5)The social support could decrease AMI patients' psychological stress. (6)Healthy life habits could decrease AMI patients' psychological stress. (7) Patients were worrying about whether they could go back to work again after the onset of AMI.
目的：(1)探讨AMI患者康复过程中不同时期的压力感受程度及其变化情况；(2)探讨AMI患者康复过程中不同时期的压力反应及其变化情况；(3)描述AMI患者康复过程中不同时期的应对方式及社会支持状况；(3)分析AMI患者康复过程中不同时期压力感受及压力反应的影响因素；(4)探索AMI患者康复过程中的压力体验。
方法：本研究包括两部分,即量性研究中的纵向调查研究和质性研究中的现象学研究。
在量性研究部分,本研究以方便抽样的方法,从2010年1月至9月,从上海市中山医院和华山医院的心内科CCU病房中,抽取符合纳入标准的AMI患者60名进行为期6个月的随访调查。采用一般资料调查表、中文版压力知觉量表(CPSS)、综合医院焦虑抑郁量表(HADS)、医学应对问卷(MCMQ)和社会支持评定量表(SSS)来评价AMI患者的一般人口社会学资料、压力感受、心理压力反应、应对方式和社会支持情况。研究分别在患者患病后7-10天、6周、3个月及6个月时发放问卷。所得数据采用SPSS15.0进行统计分析。
在质性研究部分,采用质性研究中的现象学研究方法,对15名急性心肌梗死患者在其患病后7-10天、6周、3个月及6个月分别进行深度访谈,并采用现象学分析法分析资料。
结果：量性研究：(1)AMI患者四个时间点的CPSS的得分为19.45±5.96、17.67±6.33、14.75±6.41、15.25±6.32,经过重复测量的方差分析,不同时间AMI患者的CPSS得分之间差异有统计学意义(P<0.05)。AMI患者四个时间点的健康危险性压力的发生率分别为20%、15%、8.3%、8.3%,且经卡方检验不同时间的健康危险性压力的发生率之间差异有统计学意义(P<0.05)。(2)四个时间AMI患者的焦虑得分分别为6.80±2.57、5.88±2.15、5.08±2.55及4.82±2.49,经重复测量的方差分析,不同时间患者的焦虑得分之间差异有统计学意义(P<0.05)。四个时间点AMI患者的抑郁得分分别为5.52±3.66、4.67±3.81、4.23±3.55、4.03±2.86,且不同时间的抑郁得分之间差异有统计学意义(P<0.05)。四个时间点AMI患者的焦虑阳性率为33.3%、20%、10%、11.7%,且焦虑阳性率之间差异有统计学意义(P<0.05)。四个时间点患者抑郁阳性率为33.3%、20%、23.3%、11.3%,且差异有统计学意义(P<0.05)。(3)将AMI患者四个时间点的三种应对方式得分分别与常模比较,除6周时面对得分与常模相比差异不显著,其余时间的面对得分均低于常模,且差异有统计学意义(P<0.05)；除6个月时回避得分与常模相比差异不显著,其余时间的回避得分均高于常模,且差异有统计学意义；仅在住院阶段患者的屈服应对得分高于常模,差异有统计学意义(P<0.05)。重复测量的方差分析示,不同时间AMI患者的面对和回避得分之间差异不显著,不同时间患者的屈服应对得分之间差异有统计学意义(P<0.05)。(4)四个时间点AMI患者的社会支持总分均高于常模(P<0.05),四个时间点AMI患者的主观支持、客观支持、对支持的利用度及社会支持总分之间差异无统计学意义(P>0.05)。(5)AMI患者患病后7-10天时,屈服应对、吸烟史、面对应对、职业和居住状态是患者压力感受的影响因素；心功能分级是患者焦虑反应的影响因素；社会支持总分和屈服应对是患者抑郁反应的影响因素。患者患病后6周时,屈服应对、锻炼习惯、年龄和社会支持总分是压力感受的影响因素；屈服应对、年龄和锻炼习惯是患者焦虑反应的影响因素；屈服应对、面对应对、锻炼习惯和年龄是患者抑郁反应的影响因素。患者患病后3个月时,屈服应对是压力感受、焦虑抑郁反应的影响因素；客观支持、职业和回避应对是患者抑郁反应的影响因素。患者患病后6个月时,屈服应对、锻炼习惯、心功能分级是压力感受的影响因素；屈服应对、锻炼习惯和客观支持是焦虑反应的影响因素；屈服应对和回避应对是患者抑郁反应的影响因素。
质性研究：将AMI患者急性期的压力反应归纳为三个方面：①面对现实的打击；②适应角色改变；③准备回归与重建。将AMI患者出院后6个月内的压力反应归纳为三个方面：①关注疾病康复；②生活习惯的改变；③人际关系的重建。结论(1)AMI患者住院时的压力感受程度最重,患者的压力感受在出院后前3个月下降显著,但是仍有一定程度的压力,3个月后压力感受下降不明显。(2)在住院阶段AMI患者在面对现实打击、适应角色改变及准备回归与重建的过程中出现了压力反应。出院后AMI患者由于关注疾病康复、生活习惯的改变和人际关系的重建而出现了不同的心理压力反应。(3)AMI患者较倾向于采用回避方式应对,较少采用面对方式。(4)不同应对方式在患者患病后的不同阶段有不同的影响。(5)社会支持在AMI患者患病过程中有助于减少心理压力。(6)良好的生活习惯有助于减少患者心理压力。(7)能否重返工作是AMI患者患病过程关注的问题。
Background:Acute myocardial infarction(AMI) is a serious coronary heart disease, and it has posed a health threat to people in our country. The incidence of AMI in china has been increasing these years. The onset of AMI is usually unexpected, and at the acute phase, the patients are in a very serious condition and the illness condition changes quickly. After discharging from the hospital, the patients' lifestyle and living conditions may experience significant changes. When facing with the stressors coming from the disease,environment of the hospital, or the family and society, the patients may have different stress perceptions. Some studys showed that patients with AMI had various digrees of pressure during the rehabilitation process.In our country, there are no study investigating the change of the patients'stress perception and stress response longitudinally. This study used the theory-"interaction of cognitive and stress" as the framework, and especially considered the regulating function of coping styles and social support on patients'psychological health, conducted a longitudinal study using the qulitative method combined with the quantitative evaluation to explore the stress perception and stress response of patients with AMI.
Objective:(1) To investigate the level of stress perception and its the changing trend in patients with acute myocardial infarction (AMI) during their rehabilitation process;(2)To investigate the stress response status and its changing trend in patients with AMI during their rehabilitation process;(3) To identify the coping style and the social support in patients with AMI in four periods; (4) To analyze the influential factors of stress perception and stress response status of patients with AMI in four periods during their rehabilitation process; (5) To explore the stress experiences of patients with AMI during the first 6 months after the onset of the disease.
Methods:This study includes two parts:the Longitudinal survey and the qualitative study using the phenomenology method.
In the Longitudinal survey study,60 AMI patients from the cardiology department of Zhongshan hospital and Huashan hospital, were investigated during the first 6 months in their rehabilitation process from January 2010 to September 2010. The Common status Questionnaire, The Chinese Perceived Stress Scale(CPSS),The Hospital Anxiety and Depression Scale(HADS), the Social Support Scale(SSS) and the Medical Coping Modes Questionnaire(MCMQ) were used respectively to investigate the common status, stress perception, psychological stress responses, social support conditions and coping styles of patients with AMI. The survey were conducted in four different times:7～10 days (time 1)、6 weeks (time 2)、3 months (time 3) and 6 months (time 4) after the onset of AMI. The SPSS15.0 was used for data analysis.
In the qualitative study, the phenomenology method was adopted,15 patients with AMI participated in the semi-structure interviews which were conducted in four times:7～10 days, six weeks, three months and six months after the discharge. The data was analyzed by Claizzi's phenomenological procedure.
Results:In the Longitudinal survey study:(1) The scores of CPSS scale in four times were 19.45±5.96、17.67±6.33、14.75±6.41、15.25±6.32, The repeated measure analysis of variance indicated that the level of stress perceptions were different along with the change of time (P< 0.05).The percentages of patients with stress threating to health in the four times were:20%、15%、8.3%、8.3%. The chi-square test indicated that the difference between these four percentages was significant (P <0.05). (2)The scores of anxiety in the four times were:6.80±2.57、5.88±2.15、5.08±2.55及4.82±2.49. The repeated measure analysis of variance indicated that there were significant difference between the scores of anxiety in four time points (P<0.05). The scores of depression in the four times were:5.52±3.66、4.67±3.81、4.23±3.55、4.03±2.86. The repeated measure analysis of variance indicated that there were significant difference between the scores of anxiety in four time points(P<0.05). The incidence of anxiety in the four times were:33.3%、20%、10%、11.7%, which were significantly different (P<0.05). The incidence of depression in the four times were:33.3%、20%、23.3%、11.3%, which had significant difference (P<0.05). (3) Comparing the average scores of the confrontation coping style to the norm, except the scores measured in the 6th week, the other scores were significantly lower than the norm(P<0.05). Comparing the average scores of the avoidance coping style to the norm, except the scores measured in the 6th month, the other scores were significantly higher than the norm(P<0.05). Comparing the average scores of the resignation coping style to the norm, only the score of resignation coping style measured in hospital was significantly higher than the common model (P<0.05). The repeated measure analysis of variance showed that:At different time points, the difference of the scores of confrontation coping style had no statistics significance(P >0.05), and the difference of the scores of avoidance coping style had no statistics significance(P> 0.05), but the scores of resignation coping style significance were significant different (P<0.05). (4) The whole social support scores in four time points were all higher than the common model (P<0.05). The scores of active support, objective support, utilization of support and the whole score of support had no significant change along with time(P>0.05). (5) The stepwise regression analysis showed that:during 7～10 days after the onset of AMI, the level of stress perception was influenced by resignation coping, smoking state in the past, confrontation coping, occupation and living status;the level of cardiac function may influence the incidence of anxiety; the whole score of social support and the resignation coping might influence the incidence of depression. On the time of six weeks after the onset of AMI, the level of stress perception was influenced by resignation coping,exercising status in the past, age and the whole score of social support;the resignation coping, age and exercising status in the past might influence the incidence of anxiety; the resignation coping, age, exercising status in the past and confrontation coping might influence the incidence of depression. On the time of three months after the onset of AMI, the level of stress perception and the incidence of anxiety and depression were influenced by resignation coping;the passive support, occupation and avoidance coping may influence the incidence of depression. On the time of six months after the onset of AMI, the level of stress perception was influenced by resignation coping, exercising status and the level of cardiac function;the resignation coping, exercising status and passive support might influence the incidence of anxiety; the resignation coping and the avoidance coping mmight influence the incidence of depression.
In the qualitative study:the stress response of patients at the early stage of AMI included three aspects:①facing the strike of reality;②the changing role;③preparation of going back to normal life and rebuilding. The stress response of patients with AMI when they leave hospital included three aspects:①worrying about the rehabilitation of
AMI;②changing the living habits;③rebuilding the interpersonal relationships.
Conclusions:(1) The stress perception was most significant when patients were in hospital, although the level of stress perception decreased after they discharged, patients still had some stress in life. (2) According to the semi-structure interviews, patients in hospital felt stressful during the process of facing the strike of reality, changing the role and preparing for going back to normal life and rebuilding. When patients left hospital after they discharged, they felt stressful during the process of worrying about the rehabilitation, changing the living habits and rebuilding the interpersonal relationships. (3)The patients with AMI preferred to use the avoidance coping style during the rehabilitation process, and they used the confrontation coping style less frequently than the norm. (4) AMI patients should choose different coping strategies according to different phases during the disease rehabilitation. (5)The social support could decrease AMI patients' psychological stress. (6)Healthy life habits could decrease AMI patients' psychological stress. (7) Patients were worrying about whether they could go back to work again after the onset of AMI.
引文
[1]Organization World Health. WHO's mortality database[DB/OL]. (2007-02-21). http://www.who.int/whosis/mort/en/.
[2]Cobb S L, Brown D J, Davis L L. Effective interventions for lifestyle change after myocardial infarction or coronary artery revascularization[J]. Journal of the Ame-rican Academy of Nurse Practitioners,2006,18(1):31-39.
[3]Schultz MA, Van Servellen G, Litwin MS, et al. Can hospital structural and financial characteristics explain variations in mortality caused by acute myocardial infarction[J]?Applied Nursing Research,1999,12(4):210-214.
[4]中华人民共和国卫生部.中国健康知识传播激[DB/OL]. http://www.moh.gov.cn/publ ic-files/business/htmlfiles/mohjbyfkzj/pgzdt/200804/19103.html,2008,04,11.
[5]He J, Gu DF, Wu XG, et al. Major causes of death among men and women in China[J]. New England Journal of Medicine,2005,353(11):1124-1134.
[6]叶任高.心内科学[M].北京：人民卫生出版社,2004
[7]Lazarus,R S. Psychological stress and the coping process[M].New York:McGraw · Hi-11,1966.
[8]Van Elderen T, Maes S, Dusseldorp E. Coping with coronary heart disease:A Lon-gitudinal study[J]. Journal of Psychosomatic Research,1999,47(2):175-183.
[9]Lowe R, Norman P, Bennett P. Coping, emotion and perceived health following myocardi-al infarction:Concurrent and predictive associations[J]. British Journal of Health Psychology,2000,5:337-350.
[10]Stalnikowicz R, Tsafrir A. Acute Psychosocial stress and cardiovascular events [J].Am J Emerg Med,2002,20(5):488-491.
[11]Bennett P, Lowe R, Mayfield T, et al. Coping, mood and behaviour following myocardial infarction:results of a pilot study[J]. Coronary Health Care,1999,3:192-198.
[12]黄丽,姜乾金,任蔚红.应付方法、社会支持与癌症患者心身症状的相关性研究[J].中国心理卫生杂志,1996,10(4)：160-161.
[13]Hildingh C, Fridlund B,Lidell E. Women's experiences of recovery after myocardial infarction:A meta-synthesis[J]. Heart Lung,2007,36(6):410-417.
[14]Kristofferzon M L, Lofmark R, Carlsson M. Myocardial infarction:gender differences in coping and social support[J]. Journal of Advanced Nursing,2003,44(4):360-374.
[15]Ramos I, Fernandez-Palacin F, Failde I. Predictive factors of mental disorders in patients with suspected ischaemic cardiopathy[J]. Eur J Epidemiol,2001, 17(9):835-840.
[16]Pettersen KI, Reikvam A, Rollag A, et al. Understanding sex differences in health-related quality of life following myocardial infarction[J].Int J Cardiol,2008, 130(3):449-456.
[17]Stewart AL, Greenfield S,Hays RD, et al. Functional status and well-being of patients with chronic conditions:Results from the Medical Outcomes Study [J]. Journal of the American Medical Association.1989,262(7):907-913.
[18]李瑜林,宁丽君.焦虑及抑郁情绪与急性心肌梗死及其并发症的关系[J].临床医药实践杂志,2004,13(6)：426-427.
[19]Moser DK, Dracup K. Is anxiety early after myocardial infarction associated with subsequent ischemic and arrhythmic events?[J]. Psychosom Med,1996,58(5):395-401.
[20]Gonzalez-Jaimes El, Turnbull-Plaza B. Selection of psychotherapeutic treatment for adjustment disorder with depressive mood due to acute myocardial infarction[J].Arch Med Res,2003,34(4):298-304.
[21]Lazaras RS, Folkman SM. Stress, appraisal, and coping[M]. NewYork:Springer-Verlag, 1984.
[22]戴晓阳,佟术艳.护理心理学[M].北京：人民卫生出版社,1998.
[23]姜乾金.医学心理学[M].北京：人民卫生出版,2004.
[24]肖水源,杨德森.社会支持对身心健康的影响[J].中国心理卫生杂志,1987,1(4)：183-187.
[25]程若莺,周郁秋,孟丽娜,吕雨梅.脑卒中患者生活质量量表研究进展[J].护理学杂志,2010,25(11)：91-94.
[26]中华医学会心血管病学分会,中华心血管病学杂志编辑部委员会,中国循环杂志编辑部委员会.急性心肌梗死诊断和治疗指南[J].中华心血管病杂志,2001,29(12)：710-725.
[27]Tunstall-Pedoe H, Kuulasmaa K, Mahonen M, et al. Contribution of trends in survival and coronary-event rates to changes in coronary heart disease mortality:10-year results from 37 WHO MONICA Project populations[J]. Lancet, 1999,353(9164):1547-1557.
[28]Organization World Health. WHO Cardiovascular Disease[DB/OL]. (2007-05-02). http://www.who.int/cardiovascular_diseases/en/.
[29]Dallas, Tex. Heart and Stroke Statistical Update[R]. American Heart Association, 1999.
[30]Organization World Health. WHO Cardiovascular Disease [DB/OL]. (2007-05-02). http: //www.who.int/cardiovascular diseases/en/.
[31]应飞.北京地区中、西医院急性心肌梗死患者住院治疗状况和病死率对比分析[M].北京：北京师范大学中医内科临床,2007.
[32]Cannon, W. B. Stress and strains of homeostasis[J]. American Journal of Medical Sciences,1935,189:1-14.
[33]陈会昌.应激与健康.中国心理卫生杂志,1987;1：4.
[34]Selye,H. A syndrome produced by diverse nocuous agents[J]. Nature,1936,138:32.
[35]姜乾金.心身医学[M].北京：人民卫生出版社,2007.
[36]刘晓虹.护理心理学[M].上海：上海科学技术出版社,2006.
[37]朱佩,张雅萍.ICU患者压力源与压力反应的调查及护理对策[J].护理学杂志,2008,23(18)：65-67.
[38]耿德勤,吴爱勤,张宁.医学心理学[M].南京：东南大学出版社,2003.
[39]李小妹.护理学导论[M].长沙：湖南科学技术出版社,2002.
[40]陈利群,王启元,程云.住院糖尿病病人压力源调查分析[J].护理研究,2008,22(10B)：2650-2651.
[41]连贵君,王进,李玲.烧伤患者压力源分析及护理对策[J].当代护士,2005(2)：63-64.
[42]卢惠娟,顾沛,李晓蓉,等.肝癌介人治疗病人压力和应对方式调查研究[J].护理学杂志,2003,18(7)：483-485.
[43]孙田杰,沙儒.心脏瓣膜置换术后病人心理压力的评估[J].中华护理杂志,2001,36(9)645-647.
[44]刘明,杨青,高睿等.肾移植术后病人不同时期压力源的研究与分析[J].实用护理杂志,2001,17(4)：5-6.
[45]Ballard KS.Identification of environmental stressors for patients in a surgical intensive care unit[J].Issues Ment Heath Nurs,1981,3(1-2):89-108.
[46]Cochran J, Ganong LH. A comparison of nurses and patients perceptions of intensive-care unit stressors[J]. Journal of Advanced Nursing,1989,14(12): 1038-1043.
[47]Novaes MAFP, Aronovich A,Ferraz MB, et al. Stressors in ICU:patients' evaluation[J]. Intensive Care Med,1997,23(12):1282-1285.
[48]So HM, Chan DSK. Perception of stressors by patients and nurses of critical care units in Hong Kong[J]. International Journal of Nursing Studies,2004,41(1): 77-84.
[49]Hweidi IM. Jordanian patients'perception of stressors in critical care units: A questionnaire survey[J]. International Journal of Nursing Studies,2007, 44(2):227-235.
[50]沈玮.ICU环境压力源与患者压力反应的研究[D].山东：山东大学护理学院,2006.
[51]Cornock MA. Stress and the intensive care patient:perceptions of patients and nurses[J]. Journal of Advanced Nursing,1998,27(3):518-527.
[52]Pang PSK, Suen LKP. Stressors in the intensive care unit:comparing the perceptions of Chinese patients and their family[J]. Stress and Health,2009, 25(2):151-159.
[53]Carr JA, Powers MJ. Stressors Associated with Coronary Bypass Surgery[J]. Nursing Rearch,1986,35(4):243-246.
[54]Yarcheski Adela, Knapp-Spooner Carrie. Stressors Associated with Coronary Bypass Surgery[J]. Clin Nurs Res,1994,3(1):57-68.
[55]吕探云.健康评估.北京：北京人民卫生出版社;2001.
[56]路德艳,张银萍,朱娅歌.住院病毒性肝炎病人压力源及其影响因素分析[J].护理研究,2006,20(6A)：1442-1444.
[57]杨廷忠,黄汉腾.社会转型中城市居民心理压力的流行病学研究[J].中华流行病学杂志,2003,24(9)：760-764.
[58]曹霞,周建松,谢秀梅.老年冠心病患者应对方式与心理健康状况的研究[J].医学临床研究,2006,23(9)：1466-1467.
[59]陈立英,孙玉梅,于莹,等.慢性病患者焦虑抑郁情绪与应对方式相关性研究[J].解放军护理杂志,2003,20(4)：33-34.
[60]陈先华,Pothiban L, Khampolsir T,等.急性心肌梗死病人疾病不确定感与应对方式的相关性研究[J].护理学杂志,2001,16(8)：471-472.
[61]高伟,杨敏,张秀丽,等.癌症患者应对方式与心理状况的相关性研究[J].山东大学学报(医学版),2006,44(12)：1213-1216.
[62]胡荣,姜小鹰,郑翠红.老年冠心病病人应对方式及相关因素研究[J].护理研究,2006,20(7B)：1810-1812.
[63]胡荣,姜小鹰,郑翠红.老年冠心病病人自尊与应对方式相关探究[J].中国临床心理学杂志,2007,15(2)：202-204.
[64]黄天雯,罗晓梅,江美霞.癌症疼痛病人心理状态及应对方式的调查[J].现代临床护理,2005,4(6)：7-9.
[65]李宁,熊英.不稳定型心绞痛与急性心肌梗死患者心理状况和应对方式的比较研究[J]中华护理杂志,2004,39(11)：801-803.
[66]Carr JA,Powers MJ. Stressors Associated with Coronary Bypass Surgery[J]. Nursing Rearch,1986,35(4):243-246.
[67]Pang PSK, Suen LKP. Stressors in the ICU:a comparison of patients' and nurses' perceptions[J]. Journal of Clinical Nursing,2008,17(20):2681-2689.
[68]Yarcheski A, Knapp-Spooner C. Stressors Associated with Coronary Bypass Surgery [J].Clin Nurs Res,1994,3(1):57-68.
[69]耿莉华,穆宗昭,李加宁.内科住院病人心理反应相关因素的调查及管理对策[J].护理学杂志,1999,14(4)：240-241.
[70]沈玮.ICU环境压力源与患者压力反应的研究[D].山东：山东大学护理学院,2006.
[71]Stewart M, Davidson K, Meade D, et al. Myocardial infarction:survivors' and spouses' stress, coping, andsupport[J]. Journal of Advanced Nursing.2000,31(6):1351-1360.
[72]Sjostrom-Strand A, Fridlund B. Stress in women's daily life before and after a myocardial infarction:a qualitative analysis[J].Scand J Caring Sci,2007, 21(1):10-17.
[73]曹晓霞.急诊科护士压力源、压力与应对关系的研究[D].长沙：中南大学护理学院;,2007.
[74]赵鑫.乳腺癌化疗患者疾病不确定感及其与应对方式的相关性研究[D].北京：中国协和医科大学护理学院,2007.
[75]Redeker N. S. The relationship between uncertainty and coping after coronary bypass surgery[J]. West J Nurs Res,1992;14(1):48-68.
[76]Vitaliano PP, Maiuro RD, Russo J, et al. Raw versus relative score in the assessment of coping strategies[J]. J Behav Med,1987,10(1):1-18.
[77]Tung H H, Hunter A, Jeng W, et al. Gender differences in coping and anxiety in patients after coronary artery bypass graft surgery in Taiwan[J]. Heart Lung,2009,38(6): 469-479.
[78]Logan Susan M., Pelletier-Hibbert Maryse, Hodgins Marilyn. Stressors and coping of in-hospital haemodialysis patients aged 65 years and over[J]. Journal of Advanced Nursing,2006,56(4):382-391.
[79]孟海英,常晓晓,郜玉珍.慢性心力衰竭病人疾病不确定感与应对方式的相关性研究[J].护理研究,2008,22(4)：1049-1050
[80]卢惠娟,顾沛,李晓蓉,等.肝癌介人治疗病人压力和应对方式调查研究[J].护理学杂志,2003,18(7)：483-485.
[81]沈晓红,姜乾金.医学应对方式问卷中文版701例测试报告[J].中国行为医学科学,2000,9(1)：18-20.
[81]汪向东,王希林,马弘编.心理卫生评定量表手册[M].北京：中国心理卫生杂志社,1999.
[83]张丽华.生活事件和应对方式与急性心肌梗死发病关系的配对比较[J].中国临床康复, 2003,7(18)：2538-2539.
[84]林建雄.腹膜透析患者生存质量与抑郁、社会支持及应对方式的相关性研究[D].广州：中山大学护理学院,2009.
[85]杨国亮,包天奎,朱丽.冠心病介入术患者家庭功能与应对方式间的关系研究[J].中国现代医药杂志,2005,7(1)：48-49.
[86]张伟嫦,焦淑燕,张建华,等.住院冠心病病人社会支持与应对方式关系的研究[J].护理研究,2004,18(3)：386-387.
[87]Kristofferzon M L, Lofmark R, Carlsson M. Coping, social support and quality of life over time after myocardial infarction[J]. Journal of Advanced Nursing,2005,52 (2): 113-124.
[88]Kuo CP. Stress and coping of acute myocardial infarction patients [J]. Taipei: National Taiwan University,1987.
[89]Kristofferzon M L, Lofmark R, Carlsson M. Striving for balance in daily life:Exp-eriences of Swedish women and men shortly after a myocardial infarction[J]. Journal of Clinical Nursing,2007,16(2):391-401.
[90]Sutherland Bernice, Jensen Louise. Living with Change:Elderly Women's Perceptions of Having a Myocardial Infarction[J]. Qualitative Health Research, 2000,10(5):661-676.
[91]Chiou A, Potempa K, Buschmann M B. Anxiety, depression and coping methods of Hospit-alized patients with myocardial infarction in Taiwan[J]. International Journal of Nursing Studies,1997,34(4):305-311.
[92]王征宇.症状自评量表(SCL-90)[J].上海精神医学,1984,2：68-70.
[93]谢华,戴海崎.SCL-90量表评价[J].神经疾病与精神卫生,2006,6(2)：156-159.
[94]汪向东,王希林,马弘编.心理卫生评定量表手册[J].中国心理卫生杂志,1999,12：127-129
[95]刘雪莲.慢性心力衰竭患者的抑郁及其影响因素的研究[J].广州：中山大学护理学院,2007.
[96]张作记.行为医学量表手册[M].北京：中华医学电子音像出版社,2004.
[97]刘萍萍.心衰病人焦虑抑郁调查研究[M].北京：中国协和医科大学内科学,2007.
[98]黄久荣,侯晓林,宋毅,等.2周住院心脏康复程序对急性心肌梗死患者的疗效观察[J].中国康复医学杂志,2007,22(12)：1117-1119.
[99]Pignalberi C, Patti G, Chimenti C. Role of Different Determinants of Psychological Distress in Acute Coronary Syndromes[J]. JACC,1998,32(3):613-619.
[100]位伟,侯华丽.急性心肌梗死患者症状自评量表结果分析[J].中国民康医学,2006,18(8)：698-699.
[101]文若兰,廖少玲,洪贵英.心肌梗死患者心理健康水平的研究[J].国外医学-护理学分册,2005,24(7)：345-347.
[102]朱霞东,邹文华,王民主.急性心肌梗死患者与负性情绪的相关因素探讨[J].中国民康医学,2008,20(3)：245-247.
[103]Whitehead DL, Strike P, Perkins-Porras L. Frequency of Distress and Fear of Dying During Acute Coronary Syndromes and Consequences for Adaptation[J]. Am J Cardiol,2005,96(11):1512-1516.
[104]张爱娥.急性心肌梗死患者的心理护理[J].邯郸医学高等专科学校学报,2003,16(2)：152-153.
[105]王玉玲,王社芬.急性心肌梗死患者急性期心理特点及护理对策[J].现代护理,2004,10(1)：20-21.
[106]张贵荣.谈老年冠心病人的心理护理[J].天津护理,1995,3(3)：1.
[107]Mayou RA, Gill D,Thompson DR, et al. Depression and anxiety as predictors of outcome after myocardial infarction[J]. Psychosom Med,2000,62(2):212-219.
[108]Lauzon C, Beck CA, Huynh T, et al. Depression and Prognosis Following Hospital Admission Because of Acute Myocardial Inf arct ion [J]. CMAJ,2003,168(5):547-552.
[109]Grace SL, Abbey SE, Irvine J, et al. Prospective examination of anxiety persistence and its relationship to cardiac symptoms and recurrent cardiac events[J]. Psychother Psychosom,2004,73(6):344-352.
[110]程小芸,邹文华,王民主.急性心肌梗塞患者与正常人个性特征生活事件和负性情绪对照研究[J].临床心身疾病杂志,2008,14(3)：219-221.
[111]王丽娟.急性心肌梗塞病人初期情绪反应及治疗[J].健康心理学杂志,1998,6(2)：143.
[112]宁淑娥,李萍.急性心肌梗死患者早期焦虑情绪及相关因素分析[J].中国行为医学科学,2005,14(5)：417-418.
[113]李跃洲.老年与青年急性心肌梗死患者危险因素和心理状态分析[J].实用诊断与治疗杂志,2007,21(8)：638-639.
[114]Lane D, Carroll D, Lip GYH. Anxiety, depression, and prognosis after myocardial infarction:is there a causal association? J Am Coll Cardial,2003,42(10): 1808-1810.
[115]王馥梅,张俊玲,相风兰,等.急性心肌梗死患者焦虑抑郁的发病相关性研究[J].中华 老年心脑血管病杂志,2008,10(2)：146.
[116]高海燕,张爱真,王建榜,等.老年和青年急性心肌梗死临床特点和心理分析[J].中国心血管病研究杂志,2004,2(9)：695-697.
[117]宋玲,吴秀媛.心肌梗死患者焦虑因素的调查分析与护理对策[J].齐鲁护理杂志,2000,6(4)：255-257.
[118]Moore S M. A comparison of women's and men's symptoms during home recovery after coronary artery bypass surgery[J]. Heart Lung,1995,24(6):495-501.
[119]Daly J, Elliott D, Cameron-Traub E. et al Health status, perceptions of coping, and social support immediately after discharge of survivors of acute myocardial infarction. American Journal of Critical Care 2000;9:62-69.
[120]Dixon T, Lim L, Powell H et al. Psychosocial experiences of cardiac patients in early recovery:a community-based study. J Adv Nurs 2000:31:1368-1375.
[121]贾云,邵璇.住院冠心病病人的心理状况及其影响因素研究[J].护理研究,2005,19(9A)：1714-1716.
[122]蒿光艳,杨雪珍,屈学勤.急性心肌梗死患者心理问题的分析与护理对策[J].齐鲁护理杂志,2004,10(5)：340-342.
[123]陆霞,吴瑛.急性心肌梗死患者情感障碍调查及相关因素分析[J].中国实用护理杂志,2004,20(2)：65-66.
[124]蒋晓云,高海霞.文化程度对急性心肌梗死患者焦虑情绪的影响及对策[J].山东医药,2004,44(23)：39-40.
[125]Muro MJ, Pajuelo CG, de la Calzada CS, et al. Quality of life and social support after a first, non-complicated acute myocardial infarction[J]. Revista espanola de cardiologia,1999,52(7):467-474.
[126]Nelson DV, Baer PE, Cleveland SE. Family stress management following acute myocardial infarction:an educational and skills training intervention prog-ram [J]. Patient Education and Counseling,1998,34(2):135-145.
[127]Fenner E, Michels G. SCL-90-R Scoring of Stress after Myocardial Infarction[J]. medicine clinic,2003,98(1):7-12.
[128]Katherine J, VanElderen T, Karlein S. Self-efficacy and Over-protection Are Related to Quality of Life, Psychological Well-being and Self-management in Cardiac Patients[J]. J Health Psychol,2007,12(4):4-16.
[129]林玲萍.消化性溃疡与社会支持[J].护理探究,2002,16(4)：209-210.
[130]Krishnan KRR, George LK, Pieper CF, et al. Depression and social support in elderly patients with cardiac disease[J]. American Heart Journal,1998,136 (3): 491-495.
[131]王志军,周建芝,葛庆峰,等.冠心病患者的性格类型和抑郁状态分析[J].中国民康医学,2007,19(2)：132-134.
[132]王小艳,欧尽南,杨芬,等.急性心肌梗死患者生活质量影响因素的调查研究[J].现代临床护理,2009,8(6)：8-12.
[133]Brink E, Karlson B W, Hallberg L R M. Readjustment 5 months after a first-time myocar- dial infarction:reorienting the active self. Journal of Advanced Nursing,2006,53(4):403-411.
[134]Petrie K J, Weinman J, Sharpe N, et al. Role of patients'view of their illness in predicting return to work and functioning after myocardial infarction: Longitudinalstudy[J]. British Medical Journal,1996,312(7040):1191-1194.
[135]胡雁.定性研究[M].北京：人民卫生出版社,2002.
[136]刘可.论量性研究和质性研究方法的综合运用[J].中国实用护理杂志,2006,22(11)：12-14.
[137]Lazarus RS,Delongis A, Folkman S, et al. Stress and adaptational outcomes: The problem ofconfounded mearsrues[J]. American Psychologist,1985,40(7):77 0-779.
[138]Lazarus. RS. Progress on a cognitive-motivational—relational theory of emotion[J]. American Psychologist,1991,46(8):819-834.
[139]叶晓青,王饶萍,林建雄.血液透析患者应对心理压力的方式及其影响因素[J].中国中西医结合肾病杂志,2006,7(10)：574-576.
[140]林田.2型糖尿病患者自护行为与心理一致感、抑郁的相关性研究[D].广州：中山大学护理学院,2007.
[141]黄俭强,李向芝,蔡棠,等.广州市区部分就诊的慢性阻塞性肺疾病患者呼吸锻炼知行度调查[J].中国健康教育,2002,18(3)：173-175.
[142]Barefoot JC,Helms MJ, Mark DB,et al. Depression and long-term motality risk in patients with coronary artery disease[J]. Am J Cardiol,1996,78(6): 613-617.
[143]王茂斌,曲镭.心脏疾病的康复医疗学[M].北京：人民卫生出版社,2000.
[144]Barie PS, Hydo LJ, Fischer E. Comparison of APACHE-Ⅱ and APACHE-Ⅲ scoring systems for mortality prediction in critical surgical illness[J]. Arch Surg, 1995,130(1):77-82.
[145]Whitehead DL, Strike P, Perkins-Porras L. Frequency of Distress and Fear of Dying During Acute Coronary Syndromes and Consequences for Adaptation[J]. Am J Cardiol,2005,96(11):1512-1516.
[146]李湘萍.护理干预对恢复期急性心肌梗死病人康复影响的研究[J].护理研究,2009,23(4B)：980-981.
[147]Eva B, Carina B.'Grasp life again'. A qualitative study of the motive power in myocardial infarction patients[J]. European Journal of Cardiovascular Nursing,2003,2:303-310.
[148]刘国珍.试论社会支持对压力评估与应付方式的作用[D].江西：江西师范大学,基础心理学,2001.
[149]Frasure-Smith N. In-hospital symptoms of psychological stress as predictors of long-term outcome after acute myocardial infarction in men[J]. American Journal of Cardiology,1991,67(2):121-127.
[150]Simpson T, Shaver J. Cardiovascular response to family visits in CCU patients[J]. Heart Lung,1990,19:344-351.
[151]曾静妮.心肌梗塞患者抑郁、焦虑分析及对策[J].健康心理学杂志,2002,10(2)：94-95.
[152]Dickens CM, Percival C, McGowan L, et al. The risk factors for depression in first myocardial infarction patients [J]. Psychol Med,2004,34(6):1083-1092.
[153]Kornitzer M. Psychosocial variables and coronary heart disease[J]. Acta Cardiol,2000,5(5):277-281.
[154]Chung MC, Berger Z, H Rudd. Coping with posttraumatic stress disorder and comorbidity after myocardial infarction[J]. Compr Psychiat,2008,49(1):55-64.
[155]高丽,李峥,David Arthur.(?)心肌梗死患者院外自助式心脏康复的效果研究[J].中华护理杂志,2008,43(5)：392-396.
[156]陈向明.质的研究方法与社会科学研究[M].北京：教育科学出版社,2000.
[157]夏海鸥,于美渝,陈瑜,等.乳腺癌患者对乳腺癌早期检测真实体验的质性研究[J].中华护理杂志,2005,40(9)：641-644.
[158]Nancy B, Susan KG. The practice of nursing research[M]. Saunders Company,1998.
[159]戴晓艳.CCU病人文化休克原因分析及护理对策.当代护士.2003(12)：31-32.
[160]孔海莉,许永华.重症监护病房患者应激因素的调查研究[J].解放军护理杂志,2002,19(3)：26.
[161]张燕,张琳.CCU患者压力源分析与护理对策[J].南方护理学报,2005,12(9)：70-72.
[162]李川云.改变不良生活方式对心血管疾病的防治作用[J].中国医药指南,2009,7(2)：33-34.
[163]Koertge J, Weidner G, Elliott-Eller M, et al. Improvement in Medical Risk Factors and Quality of Life in Women and Men With Coronary Artery Disease in the Multicenter Lifestyle Demonstration Project[J]. Am J Cardiol,2003, 91 (11):1316-1322.
[164]杨黎,张晓明,杨红梅.冠心病与心理社会因素相关性的研究进展[J].护理研究,2008,22(11)：30133015.
[165]Roebuck A, Furze G,Thompson DR. Health-related quality of life after myocardial infarction:an interview study[J]. Journal of Advanced Nursing, 2001,34(6):787-794.
[167]Jenson BO, Petersson K. The illness experiences of patients after a first time myocardial infarction[J]. Patient Education and Counseling,2003,51(2): 123-131.
[168]Kristofferzon ML, Lofmark R, Carlsson M. Managing consequences and finding hope-experiences of Swedish women and men 4-6 months after myocardial infarction[J].Scand J Caring Sci,2008,22(3):367-375.
[169]杨英.急性心肌梗死患者恢复期健康教育开展状况的调查[J].现代中西医结合杂志,2004,13(22)：3068-3069.
[2]Cobb S L, Brown D J, Davis L L. Effective interventions for lifestyle change after myocardial infarction or coronary artery revascularization[J]. Journal of the Ame-rican Academy of Nurse Practitioners,2006,18(1):31-39.
[3]Schultz MA, Van Servellen G, Litwin MS, et al. Can hospital structural and financial characteristics explain variations in mortality caused by acute myocardial infarction[J]?Applied Nursing Research,1999,12(4):210-214.
[4]中华人民共和国卫生部.中国健康知识传播激[DB/OL]. http://www.moh.gov.cn/publ ic-files/business/htmlfiles/mohjbyfkzj/pgzdt/200804/19103.html,2008,04,11.
[5]He J, Gu DF, Wu XG, et al. Major causes of death among men and women in China[J]. New England Journal of Medicine,2005,353(11):1124-1134.
[6]叶任高.心内科学[M].北京：人民卫生出版社,2004
[7]Lazarus,R S. Psychological stress and the coping process[M].New York:McGraw · Hi-11,1966.
[8]Van Elderen T, Maes S, Dusseldorp E. Coping with coronary heart disease:A Lon-gitudinal study[J]. Journal of Psychosomatic Research,1999,47(2):175-183.
[9]Lowe R, Norman P, Bennett P. Coping, emotion and perceived health following myocardi-al infarction:Concurrent and predictive associations[J]. British Journal of Health Psychology,2000,5:337-350.
[10]Stalnikowicz R, Tsafrir A. Acute Psychosocial stress and cardiovascular events [J].Am J Emerg Med,2002,20(5):488-491.
[11]Bennett P, Lowe R, Mayfield T, et al. Coping, mood and behaviour following myocardial infarction:results of a pilot study[J]. Coronary Health Care,1999,3:192-198.
[12]黄丽,姜乾金,任蔚红.应付方法、社会支持与癌症患者心身症状的相关性研究[J].中国心理卫生杂志,1996,10(4)：160-161.
[13]Hildingh C, Fridlund B,Lidell E. Women's experiences of recovery after myocardial infarction:A meta-synthesis[J]. Heart Lung,2007,36(6):410-417.
[14]Kristofferzon M L, Lofmark R, Carlsson M. Myocardial infarction:gender differences in coping and social support[J]. Journal of Advanced Nursing,2003,44(4):360-374.
[15]Ramos I, Fernandez-Palacin F, Failde I. Predictive factors of mental disorders in patients with suspected ischaemic cardiopathy[J]. Eur J Epidemiol,2001, 17(9):835-840.
[16]Pettersen KI, Reikvam A, Rollag A, et al. Understanding sex differences in health-related quality of life following myocardial infarction[J].Int J Cardiol,2008, 130(3):449-456.
[17]Stewart AL, Greenfield S,Hays RD, et al. Functional status and well-being of patients with chronic conditions:Results from the Medical Outcomes Study [J]. Journal of the American Medical Association.1989,262(7):907-913.
[18]李瑜林,宁丽君.焦虑及抑郁情绪与急性心肌梗死及其并发症的关系[J].临床医药实践杂志,2004,13(6)：426-427.
[19]Moser DK, Dracup K. Is anxiety early after myocardial infarction associated with subsequent ischemic and arrhythmic events?[J]. Psychosom Med,1996,58(5):395-401.
[20]Gonzalez-Jaimes El, Turnbull-Plaza B. Selection of psychotherapeutic treatment for adjustment disorder with depressive mood due to acute myocardial infarction[J].Arch Med Res,2003,34(4):298-304.
[21]Lazaras RS, Folkman SM. Stress, appraisal, and coping[M]. NewYork:Springer-Verlag, 1984.
[22]戴晓阳,佟术艳.护理心理学[M].北京：人民卫生出版社,1998.
[23]姜乾金.医学心理学[M].北京：人民卫生出版,2004.
[24]肖水源,杨德森.社会支持对身心健康的影响[J].中国心理卫生杂志,1987,1(4)：183-187.
[25]程若莺,周郁秋,孟丽娜,吕雨梅.脑卒中患者生活质量量表研究进展[J].护理学杂志,2010,25(11)：91-94.
[26]中华医学会心血管病学分会,中华心血管病学杂志编辑部委员会,中国循环杂志编辑部委员会.急性心肌梗死诊断和治疗指南[J].中华心血管病杂志,2001,29(12)：710-725.
[27]Tunstall-Pedoe H, Kuulasmaa K, Mahonen M, et al. Contribution of trends in survival and coronary-event rates to changes in coronary heart disease mortality:10-year results from 37 WHO MONICA Project populations[J]. Lancet, 1999,353(9164):1547-1557.
[28]Organization World Health. WHO Cardiovascular Disease[DB/OL]. (2007-05-02). http://www.who.int/cardiovascular_diseases/en/.
[29]Dallas, Tex. Heart and Stroke Statistical Update[R]. American Heart Association, 1999.
[30]Organization World Health. WHO Cardiovascular Disease [DB/OL]. (2007-05-02). http: //www.who.int/cardiovascular diseases/en/.
[31]应飞.北京地区中、西医院急性心肌梗死患者住院治疗状况和病死率对比分析[M].北京：北京师范大学中医内科临床,2007.
[32]Cannon, W. B. Stress and strains of homeostasis[J]. American Journal of Medical Sciences,1935,189:1-14.
[33]陈会昌.应激与健康.中国心理卫生杂志,1987;1：4.
[34]Selye,H. A syndrome produced by diverse nocuous agents[J]. Nature,1936,138:32.
[35]姜乾金.心身医学[M].北京：人民卫生出版社,2007.
[36]刘晓虹.护理心理学[M].上海：上海科学技术出版社,2006.
[37]朱佩,张雅萍.ICU患者压力源与压力反应的调查及护理对策[J].护理学杂志,2008,23(18)：65-67.
[38]耿德勤,吴爱勤,张宁.医学心理学[M].南京：东南大学出版社,2003.
[39]李小妹.护理学导论[M].长沙：湖南科学技术出版社,2002.
[40]陈利群,王启元,程云.住院糖尿病病人压力源调查分析[J].护理研究,2008,22(10B)：2650-2651.
[41]连贵君,王进,李玲.烧伤患者压力源分析及护理对策[J].当代护士,2005(2)：63-64.
[42]卢惠娟,顾沛,李晓蓉,等.肝癌介人治疗病人压力和应对方式调查研究[J].护理学杂志,2003,18(7)：483-485.
[43]孙田杰,沙儒.心脏瓣膜置换术后病人心理压力的评估[J].中华护理杂志,2001,36(9)645-647.
[44]刘明,杨青,高睿等.肾移植术后病人不同时期压力源的研究与分析[J].实用护理杂志,2001,17(4)：5-6.
[45]Ballard KS.Identification of environmental stressors for patients in a surgical intensive care unit[J].Issues Ment Heath Nurs,1981,3(1-2):89-108.
[46]Cochran J, Ganong LH. A comparison of nurses and patients perceptions of intensive-care unit stressors[J]. Journal of Advanced Nursing,1989,14(12): 1038-1043.
[47]Novaes MAFP, Aronovich A,Ferraz MB, et al. Stressors in ICU:patients' evaluation[J]. Intensive Care Med,1997,23(12):1282-1285.
[48]So HM, Chan DSK. Perception of stressors by patients and nurses of critical care units in Hong Kong[J]. International Journal of Nursing Studies,2004,41(1): 77-84.
[49]Hweidi IM. Jordanian patients'perception of stressors in critical care units: A questionnaire survey[J]. International Journal of Nursing Studies,2007, 44(2):227-235.
[50]沈玮.ICU环境压力源与患者压力反应的研究[D].山东：山东大学护理学院,2006.
[51]Cornock MA. Stress and the intensive care patient:perceptions of patients and nurses[J]. Journal of Advanced Nursing,1998,27(3):518-527.
[52]Pang PSK, Suen LKP. Stressors in the intensive care unit:comparing the perceptions of Chinese patients and their family[J]. Stress and Health,2009, 25(2):151-159.
[53]Carr JA, Powers MJ. Stressors Associated with Coronary Bypass Surgery[J]. Nursing Rearch,1986,35(4):243-246.
[54]Yarcheski Adela, Knapp-Spooner Carrie. Stressors Associated with Coronary Bypass Surgery[J]. Clin Nurs Res,1994,3(1):57-68.
[55]吕探云.健康评估.北京：北京人民卫生出版社;2001.
[56]路德艳,张银萍,朱娅歌.住院病毒性肝炎病人压力源及其影响因素分析[J].护理研究,2006,20(6A)：1442-1444.
[57]杨廷忠,黄汉腾.社会转型中城市居民心理压力的流行病学研究[J].中华流行病学杂志,2003,24(9)：760-764.
[58]曹霞,周建松,谢秀梅.老年冠心病患者应对方式与心理健康状况的研究[J].医学临床研究,2006,23(9)：1466-1467.
[59]陈立英,孙玉梅,于莹,等.慢性病患者焦虑抑郁情绪与应对方式相关性研究[J].解放军护理杂志,2003,20(4)：33-34.
[60]陈先华,Pothiban L, Khampolsir T,等.急性心肌梗死病人疾病不确定感与应对方式的相关性研究[J].护理学杂志,2001,16(8)：471-472.
[61]高伟,杨敏,张秀丽,等.癌症患者应对方式与心理状况的相关性研究[J].山东大学学报(医学版),2006,44(12)：1213-1216.
[62]胡荣,姜小鹰,郑翠红.老年冠心病病人应对方式及相关因素研究[J].护理研究,2006,20(7B)：1810-1812.
[63]胡荣,姜小鹰,郑翠红.老年冠心病病人自尊与应对方式相关探究[J].中国临床心理学杂志,2007,15(2)：202-204.
[64]黄天雯,罗晓梅,江美霞.癌症疼痛病人心理状态及应对方式的调查[J].现代临床护理,2005,4(6)：7-9.
[65]李宁,熊英.不稳定型心绞痛与急性心肌梗死患者心理状况和应对方式的比较研究[J]中华护理杂志,2004,39(11)：801-803.
[66]Carr JA,Powers MJ. Stressors Associated with Coronary Bypass Surgery[J]. Nursing Rearch,1986,35(4):243-246.
[67]Pang PSK, Suen LKP. Stressors in the ICU:a comparison of patients' and nurses' perceptions[J]. Journal of Clinical Nursing,2008,17(20):2681-2689.
[68]Yarcheski A, Knapp-Spooner C. Stressors Associated with Coronary Bypass Surgery [J].Clin Nurs Res,1994,3(1):57-68.
[69]耿莉华,穆宗昭,李加宁.内科住院病人心理反应相关因素的调查及管理对策[J].护理学杂志,1999,14(4)：240-241.
[70]沈玮.ICU环境压力源与患者压力反应的研究[D].山东：山东大学护理学院,2006.
[71]Stewart M, Davidson K, Meade D, et al. Myocardial infarction:survivors' and spouses' stress, coping, andsupport[J]. Journal of Advanced Nursing.2000,31(6):1351-1360.
[72]Sjostrom-Strand A, Fridlund B. Stress in women's daily life before and after a myocardial infarction:a qualitative analysis[J].Scand J Caring Sci,2007, 21(1):10-17.
[73]曹晓霞.急诊科护士压力源、压力与应对关系的研究[D].长沙：中南大学护理学院;,2007.
[74]赵鑫.乳腺癌化疗患者疾病不确定感及其与应对方式的相关性研究[D].北京：中国协和医科大学护理学院,2007.
[75]Redeker N. S. The relationship between uncertainty and coping after coronary bypass surgery[J]. West J Nurs Res,1992;14(1):48-68.
[76]Vitaliano PP, Maiuro RD, Russo J, et al. Raw versus relative score in the assessment of coping strategies[J]. J Behav Med,1987,10(1):1-18.
[77]Tung H H, Hunter A, Jeng W, et al. Gender differences in coping and anxiety in patients after coronary artery bypass graft surgery in Taiwan[J]. Heart Lung,2009,38(6): 469-479.
[78]Logan Susan M., Pelletier-Hibbert Maryse, Hodgins Marilyn. Stressors and coping of in-hospital haemodialysis patients aged 65 years and over[J]. Journal of Advanced Nursing,2006,56(4):382-391.
[79]孟海英,常晓晓,郜玉珍.慢性心力衰竭病人疾病不确定感与应对方式的相关性研究[J].护理研究,2008,22(4)：1049-1050
[80]卢惠娟,顾沛,李晓蓉,等.肝癌介人治疗病人压力和应对方式调查研究[J].护理学杂志,2003,18(7)：483-485.
[81]沈晓红,姜乾金.医学应对方式问卷中文版701例测试报告[J].中国行为医学科学,2000,9(1)：18-20.
[81]汪向东,王希林,马弘编.心理卫生评定量表手册[M].北京：中国心理卫生杂志社,1999.
[83]张丽华.生活事件和应对方式与急性心肌梗死发病关系的配对比较[J].中国临床康复, 2003,7(18)：2538-2539.
[84]林建雄.腹膜透析患者生存质量与抑郁、社会支持及应对方式的相关性研究[D].广州：中山大学护理学院,2009.
[85]杨国亮,包天奎,朱丽.冠心病介入术患者家庭功能与应对方式间的关系研究[J].中国现代医药杂志,2005,7(1)：48-49.
[86]张伟嫦,焦淑燕,张建华,等.住院冠心病病人社会支持与应对方式关系的研究[J].护理研究,2004,18(3)：386-387.
[87]Kristofferzon M L, Lofmark R, Carlsson M. Coping, social support and quality of life over time after myocardial infarction[J]. Journal of Advanced Nursing,2005,52 (2): 113-124.
[88]Kuo CP. Stress and coping of acute myocardial infarction patients [J]. Taipei: National Taiwan University,1987.
[89]Kristofferzon M L, Lofmark R, Carlsson M. Striving for balance in daily life:Exp-eriences of Swedish women and men shortly after a myocardial infarction[J]. Journal of Clinical Nursing,2007,16(2):391-401.
[90]Sutherland Bernice, Jensen Louise. Living with Change:Elderly Women's Perceptions of Having a Myocardial Infarction[J]. Qualitative Health Research, 2000,10(5):661-676.
[91]Chiou A, Potempa K, Buschmann M B. Anxiety, depression and coping methods of Hospit-alized patients with myocardial infarction in Taiwan[J]. International Journal of Nursing Studies,1997,34(4):305-311.
[92]王征宇.症状自评量表(SCL-90)[J].上海精神医学,1984,2：68-70.
[93]谢华,戴海崎.SCL-90量表评价[J].神经疾病与精神卫生,2006,6(2)：156-159.
[94]汪向东,王希林,马弘编.心理卫生评定量表手册[J].中国心理卫生杂志,1999,12：127-129
[95]刘雪莲.慢性心力衰竭患者的抑郁及其影响因素的研究[J].广州：中山大学护理学院,2007.
[96]张作记.行为医学量表手册[M].北京：中华医学电子音像出版社,2004.
[97]刘萍萍.心衰病人焦虑抑郁调查研究[M].北京：中国协和医科大学内科学,2007.
[98]黄久荣,侯晓林,宋毅,等.2周住院心脏康复程序对急性心肌梗死患者的疗效观察[J].中国康复医学杂志,2007,22(12)：1117-1119.
[99]Pignalberi C, Patti G, Chimenti C. Role of Different Determinants of Psychological Distress in Acute Coronary Syndromes[J]. JACC,1998,32(3):613-619.
[100]位伟,侯华丽.急性心肌梗死患者症状自评量表结果分析[J].中国民康医学,2006,18(8)：698-699.
[101]文若兰,廖少玲,洪贵英.心肌梗死患者心理健康水平的研究[J].国外医学-护理学分册,2005,24(7)：345-347.
[102]朱霞东,邹文华,王民主.急性心肌梗死患者与负性情绪的相关因素探讨[J].中国民康医学,2008,20(3)：245-247.
[103]Whitehead DL, Strike P, Perkins-Porras L. Frequency of Distress and Fear of Dying During Acute Coronary Syndromes and Consequences for Adaptation[J]. Am J Cardiol,2005,96(11):1512-1516.
[104]张爱娥.急性心肌梗死患者的心理护理[J].邯郸医学高等专科学校学报,2003,16(2)：152-153.
[105]王玉玲,王社芬.急性心肌梗死患者急性期心理特点及护理对策[J].现代护理,2004,10(1)：20-21.
[106]张贵荣.谈老年冠心病人的心理护理[J].天津护理,1995,3(3)：1.
[107]Mayou RA, Gill D,Thompson DR, et al. Depression and anxiety as predictors of outcome after myocardial infarction[J]. Psychosom Med,2000,62(2):212-219.
[108]Lauzon C, Beck CA, Huynh T, et al. Depression and Prognosis Following Hospital Admission Because of Acute Myocardial Inf arct ion [J]. CMAJ,2003,168(5):547-552.
[109]Grace SL, Abbey SE, Irvine J, et al. Prospective examination of anxiety persistence and its relationship to cardiac symptoms and recurrent cardiac events[J]. Psychother Psychosom,2004,73(6):344-352.
[110]程小芸,邹文华,王民主.急性心肌梗塞患者与正常人个性特征生活事件和负性情绪对照研究[J].临床心身疾病杂志,2008,14(3)：219-221.
[111]王丽娟.急性心肌梗塞病人初期情绪反应及治疗[J].健康心理学杂志,1998,6(2)：143.
[112]宁淑娥,李萍.急性心肌梗死患者早期焦虑情绪及相关因素分析[J].中国行为医学科学,2005,14(5)：417-418.
[113]李跃洲.老年与青年急性心肌梗死患者危险因素和心理状态分析[J].实用诊断与治疗杂志,2007,21(8)：638-639.
[114]Lane D, Carroll D, Lip GYH. Anxiety, depression, and prognosis after myocardial infarction:is there a causal association? J Am Coll Cardial,2003,42(10): 1808-1810.
[115]王馥梅,张俊玲,相风兰,等.急性心肌梗死患者焦虑抑郁的发病相关性研究[J].中华 老年心脑血管病杂志,2008,10(2)：146.
[116]高海燕,张爱真,王建榜,等.老年和青年急性心肌梗死临床特点和心理分析[J].中国心血管病研究杂志,2004,2(9)：695-697.
[117]宋玲,吴秀媛.心肌梗死患者焦虑因素的调查分析与护理对策[J].齐鲁护理杂志,2000,6(4)：255-257.
[118]Moore S M. A comparison of women's and men's symptoms during home recovery after coronary artery bypass surgery[J]. Heart Lung,1995,24(6):495-501.
[119]Daly J, Elliott D, Cameron-Traub E. et al Health status, perceptions of coping, and social support immediately after discharge of survivors of acute myocardial infarction. American Journal of Critical Care 2000;9:62-69.
[120]Dixon T, Lim L, Powell H et al. Psychosocial experiences of cardiac patients in early recovery:a community-based study. J Adv Nurs 2000:31:1368-1375.
[121]贾云,邵璇.住院冠心病病人的心理状况及其影响因素研究[J].护理研究,2005,19(9A)：1714-1716.
[122]蒿光艳,杨雪珍,屈学勤.急性心肌梗死患者心理问题的分析与护理对策[J].齐鲁护理杂志,2004,10(5)：340-342.
[123]陆霞,吴瑛.急性心肌梗死患者情感障碍调查及相关因素分析[J].中国实用护理杂志,2004,20(2)：65-66.
[124]蒋晓云,高海霞.文化程度对急性心肌梗死患者焦虑情绪的影响及对策[J].山东医药,2004,44(23)：39-40.
[125]Muro MJ, Pajuelo CG, de la Calzada CS, et al. Quality of life and social support after a first, non-complicated acute myocardial infarction[J]. Revista espanola de cardiologia,1999,52(7):467-474.
[126]Nelson DV, Baer PE, Cleveland SE. Family stress management following acute myocardial infarction:an educational and skills training intervention prog-ram [J]. Patient Education and Counseling,1998,34(2):135-145.
[127]Fenner E, Michels G. SCL-90-R Scoring of Stress after Myocardial Infarction[J]. medicine clinic,2003,98(1):7-12.
[128]Katherine J, VanElderen T, Karlein S. Self-efficacy and Over-protection Are Related to Quality of Life, Psychological Well-being and Self-management in Cardiac Patients[J]. J Health Psychol,2007,12(4):4-16.
[129]林玲萍.消化性溃疡与社会支持[J].护理探究,2002,16(4)：209-210.
[130]Krishnan KRR, George LK, Pieper CF, et al. Depression and social support in elderly patients with cardiac disease[J]. American Heart Journal,1998,136 (3): 491-495.
[131]王志军,周建芝,葛庆峰,等.冠心病患者的性格类型和抑郁状态分析[J].中国民康医学,2007,19(2)：132-134.
[132]王小艳,欧尽南,杨芬,等.急性心肌梗死患者生活质量影响因素的调查研究[J].现代临床护理,2009,8(6)：8-12.
[133]Brink E, Karlson B W, Hallberg L R M. Readjustment 5 months after a first-time myocar- dial infarction:reorienting the active self. Journal of Advanced Nursing,2006,53(4):403-411.
[134]Petrie K J, Weinman J, Sharpe N, et al. Role of patients'view of their illness in predicting return to work and functioning after myocardial infarction: Longitudinalstudy[J]. British Medical Journal,1996,312(7040):1191-1194.
[135]胡雁.定性研究[M].北京：人民卫生出版社,2002.
[136]刘可.论量性研究和质性研究方法的综合运用[J].中国实用护理杂志,2006,22(11)：12-14.
[137]Lazarus RS,Delongis A, Folkman S, et al. Stress and adaptational outcomes: The problem ofconfounded mearsrues[J]. American Psychologist,1985,40(7):77 0-779.
[138]Lazarus. RS. Progress on a cognitive-motivational—relational theory of emotion[J]. American Psychologist,1991,46(8):819-834.
[139]叶晓青,王饶萍,林建雄.血液透析患者应对心理压力的方式及其影响因素[J].中国中西医结合肾病杂志,2006,7(10)：574-576.
[140]林田.2型糖尿病患者自护行为与心理一致感、抑郁的相关性研究[D].广州：中山大学护理学院,2007.
[141]黄俭强,李向芝,蔡棠,等.广州市区部分就诊的慢性阻塞性肺疾病患者呼吸锻炼知行度调查[J].中国健康教育,2002,18(3)：173-175.
[142]Barefoot JC,Helms MJ, Mark DB,et al. Depression and long-term motality risk in patients with coronary artery disease[J]. Am J Cardiol,1996,78(6): 613-617.
[143]王茂斌,曲镭.心脏疾病的康复医疗学[M].北京：人民卫生出版社,2000.
[144]Barie PS, Hydo LJ, Fischer E. Comparison of APACHE-Ⅱ and APACHE-Ⅲ scoring systems for mortality prediction in critical surgical illness[J]. Arch Surg, 1995,130(1):77-82.
[145]Whitehead DL, Strike P, Perkins-Porras L. Frequency of Distress and Fear of Dying During Acute Coronary Syndromes and Consequences for Adaptation[J]. Am J Cardiol,2005,96(11):1512-1516.
[146]李湘萍.护理干预对恢复期急性心肌梗死病人康复影响的研究[J].护理研究,2009,23(4B)：980-981.
[147]Eva B, Carina B.'Grasp life again'. A qualitative study of the motive power in myocardial infarction patients[J]. European Journal of Cardiovascular Nursing,2003,2:303-310.
[148]刘国珍.试论社会支持对压力评估与应付方式的作用[D].江西：江西师范大学,基础心理学,2001.
[149]Frasure-Smith N. In-hospital symptoms of psychological stress as predictors of long-term outcome after acute myocardial infarction in men[J]. American Journal of Cardiology,1991,67(2):121-127.
[150]Simpson T, Shaver J. Cardiovascular response to family visits in CCU patients[J]. Heart Lung,1990,19:344-351.
[151]曾静妮.心肌梗塞患者抑郁、焦虑分析及对策[J].健康心理学杂志,2002,10(2)：94-95.
[152]Dickens CM, Percival C, McGowan L, et al. The risk factors for depression in first myocardial infarction patients [J]. Psychol Med,2004,34(6):1083-1092.
[153]Kornitzer M. Psychosocial variables and coronary heart disease[J]. Acta Cardiol,2000,5(5):277-281.
[154]Chung MC, Berger Z, H Rudd. Coping with posttraumatic stress disorder and comorbidity after myocardial infarction[J]. Compr Psychiat,2008,49(1):55-64.
[155]高丽,李峥,David Arthur.(?)心肌梗死患者院外自助式心脏康复的效果研究[J].中华护理杂志,2008,43(5)：392-396.
[156]陈向明.质的研究方法与社会科学研究[M].北京：教育科学出版社,2000.
[157]夏海鸥,于美渝,陈瑜,等.乳腺癌患者对乳腺癌早期检测真实体验的质性研究[J].中华护理杂志,2005,40(9)：641-644.
[158]Nancy B, Susan KG. The practice of nursing research[M]. Saunders Company,1998.
[159]戴晓艳.CCU病人文化休克原因分析及护理对策.当代护士.2003(12)：31-32.
[160]孔海莉,许永华.重症监护病房患者应激因素的调查研究[J].解放军护理杂志,2002,19(3)：26.
[161]张燕,张琳.CCU患者压力源分析与护理对策[J].南方护理学报,2005,12(9)：70-72.
[162]李川云.改变不良生活方式对心血管疾病的防治作用[J].中国医药指南,2009,7(2)：33-34.
[163]Koertge J, Weidner G, Elliott-Eller M, et al. Improvement in Medical Risk Factors and Quality of Life in Women and Men With Coronary Artery Disease in the Multicenter Lifestyle Demonstration Project[J]. Am J Cardiol,2003, 91 (11):1316-1322.
[164]杨黎,张晓明,杨红梅.冠心病与心理社会因素相关性的研究进展[J].护理研究,2008,22(11)：30133015.
[165]Roebuck A, Furze G,Thompson DR. Health-related quality of life after myocardial infarction:an interview study[J]. Journal of Advanced Nursing, 2001,34(6):787-794.
[167]Jenson BO, Petersson K. The illness experiences of patients after a first time myocardial infarction[J]. Patient Education and Counseling,2003,51(2): 123-131.
[168]Kristofferzon ML, Lofmark R, Carlsson M. Managing consequences and finding hope-experiences of Swedish women and men 4-6 months after myocardial infarction[J].Scand J Caring Sci,2008,22(3):367-375.
[169]杨英.急性心肌梗死患者恢复期健康教育开展状况的调查[J].现代中西医结合杂志,2004,13(22)：3068-3069.