Best Practice in Psychological Activities in Cardiovascular Prevention and Rehabilitation：Essentials of the GICR-IACPR Position Paper

doi:10.12114/j.issn.1007-9572.2019.00.171

Abstract

Abstract: The Italian Association for Cardiovascular Prevention，Rehabilitation and Epidemiology（GICR-IACPR） published a position paper on best psychological practice in cardiovascular prevention and rehabilitation（CPR） in October 2018.Based on the National Institute for Health and Care Excellence（NICE） Guidelines on psychological interventions on anxiety and depression，this position paper divides psychological practice in CPR into three steps：step one includes psychological evaluation and dynamic monitoring；step two includes low-intensity interventions，which are suitable for patients with less severe and/or the recent onset of diseases；step three includes high-intensity interventions，which are available for patients with poor outcomes in low-intensity interventions or worsening conditions over time.Psychological interventions here are divided into two levels according to NICE model.The low-intensity interventions include counseling，psycho-education，self-care，self-management，telemedicine，and self-help.The high-intensity interventions include individual，couples，and/or family and group psychotherapy，such as stress management.This position paper is a summary of a large number of latest literature and guidelines with strong operability.Compared with the psychological prescriptions in the current cardiovascular rehabilitation practice in China，this position paper is more comprehensive and detailed.Therefore，it can provide a normative reference for the psychological staff engaged in CPR in China.

Key words: Cardiovascular diseases, Psychological intervention, Psychotherapy, Universal preautions, Rehabilitation, Coronary disease, Psychology-cardiology medicine

摘要： 2018年10月，意大利心血管预防康复和流行病学协会（GICR-IACPR）发表了“心血管疾病预防和康复（CPR）最佳心理实践意见书（以下简称意见书）”。意见书借鉴英国国家健康和护理研究所（NICE）焦虑抑郁障碍心理干预指南，将CPR中的心理实践分为3步：心理评估及动态监测；低强度干预，适用于较轻疾病或近期发病的患者；高强度干预，适用于低强度干预效果不佳或随时间推移病情恶化的患者。将心理干预分为两级，低强度干预：咨询、心理教育、自我保健、自我管理、远程医疗、自我帮助等；高强度干预：个人、夫妻、家庭和团体心理治疗、压力管理等。该意见书综述了大量最新的文献和指南，可操作性强，与我国当前心脏康复实践中的心理处方相比，内容更加全面细致，可为国内从事CPR的心理工作人员提供规范参考。

关键词: 心血管疾病, 心理干预, 心理疗法, 综合预防, 康复, 冠心病, 双心医学

MA Wenlin. Best Practice in Psychological Activities in Cardiovascular Prevention and Rehabilitation：Essentials of the GICR-IACPR Position Paper　[J]. Chinese General Practice, 2019, 22(18): 2151-2155. DOI: 10.12114/j.issn.1007-9572.2019.00.171.
马文林. GICR-IACPR心血管疾病预防和康复最佳心理实践意见书精要[J]. 中国全科医学, 2019, 22(18): 2151-2155. DOI: 10.12114/j.issn.1007-9572.2019.00.171.

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