冠心病患者自责归因的研究进展

Research Progress on Self-Blame Attribution in Patients with Coronary Heart Disease

摘要: 自责归因是冠心病(Coronary Heart Disease, CHD)患者在疾病认知与心理适应过程中的核心负性认知反应，其与患者的情绪调节、健康行为依从性及长期康复结局密切相关。本文基于国内外近十年的相关研究，系统梳理了冠心病患者自责归因的概念界定与维度划分、测量工具的开发与本土化验证、现状水平与潜在类别特征、影响因素及其与核心结局变量的相关性研究。研究表明，冠心病自责归因主要分为行为自责与性格自责两个维度，中文版量表已具备良好信效度；患者自责归因水平呈中等程度，且存在明显的潜在分类；感知控制、家庭关怀及社会支持是关键的影响因素。针对当前研究现状，本文深入剖析了现有研究在纵向追踪、干预机制及样本代表性等方面的不足，并提出未来应开展多中心大样本纵向研究，构建本土化精准干预方案，以改善冠心病患者的心理康复质量。

Abstract: Self-blame attributions are core negative cognitive responses in patients with Coronary Heart Disease (CHD) during the process of disease cognition and psychological adaptation, which are closely related to patients’ emotional regulation, health behavior compliance, and long-term rehabilitation outcomes. Based on domestic and international research in the past decade, this paper systematically reviews the conceptual definition and dimensional division of self-blame attributions in CHD patients, the development and localized validation of measurement tools, the current status and latent class characteristics, influencing factors, and correlational studies with core outcome variables. Studies have shown that self-blame attributions in CHD are mainly divided into two dimensions: behavioral self-blame and characterological self-blame, and the Chinese version of the scale has good reliability and validity. The level of self-blame attributions among patients is moderate, with obvious latent classifications. Perceived control, family care, and social support are key influencing factors. Focusing on the current research status, this paper deeply analyzes the deficiencies of existing research in longitudinal tracking, intervention mechanisms, and sample representativeness. It is proposed that future research should carry out multicenter large-sample longitudinal studies to construct a localized precise intervention plan, so as to improve the quality of psychological rehabilitation of CHD patients.