DeMaso David Ray, Lauretti Allison, Spieth Leslie, van der Feen Julie R, Jay Kathleen S, Gauvreau Kimberlee, Walsh Edward P, Berul Charles I
Department of Psychiatry, Children's Hospital Boston, Boston, Massachusetts 02115, USA.
Am J Cardiol. 2004 Mar 1;93(5):582-7. doi: 10.1016/j.amjcard.2003.11.022.
Few data exist on the quality of life in children and adolescents with implantable cardioverter-defibrillators (ICDs). The objective of this study was to determine whether anxiety, depression, family functioning, and quality of life are related to cardiac illness severity in pediatric patients with ICDs. The subjects were 20 patients (mean age 14.8 years; median 15.1, range 9 to 19) who had an ICD implantation a mean 1.4 years (median 0.1, range 0 to 6) before the study. The patients completed the Revised Children's Manifest Anxiety Scale, Reynold's Adolescent/Child Depression Scales, Child Health Questionnaire-87, and the Worries About ICDs Scale. The parents completed the Impact-on-Family Scale and the Child Health Questionnaire (CHQ-50). The Defibrillator Severity Index assessed cardiac severity. The rates of anxiety or depression were not increased, although the patients appeared to experience a greater need for social acceptance. Parent ratings of overall family functioning did not differ significantly from normative sample means. Parents reported significantly lower CHQ-50 summary physical functioning scores than scores of a normative United States sample, whereas there was no significant difference for the CHQ-50 summary psychosocial score. Caregivers perceived that their children had a lower quality of life when asked about their child's physical functioning, functioning in the social-physical role, and general health perceptions. Despite the overall nonsignificance of the psychosocial summary score, the social emotional/behavioral role, and the emotional impact their child's health had on themselves, subscales were all significantly lower than the normative sample. Cardiac illness severity was not significantly associated with anxiety, depression, quality of life, or family functioning. However, significant associations were found among measures of anxiety, depression, family functioning, and quality of life. Overall, most pediatric patients with ICDs appear to be a resilient group of youngsters. Their quality of life was more strongly correlated with their feelings of anxiety and depression as well as their family functioning than to the severity of their cardiac illness.
关于植入式心脏复律除颤器（ICD）的儿童和青少年的生活质量，现有数据较少。本研究的目的是确定焦虑、抑郁、家庭功能和生活质量是否与患有ICD的儿科患者的心脏疾病严重程度相关。研究对象为20例患者（平均年龄14.8岁；中位数15.1岁，范围9至19岁），他们在研究前平均1.4年（中位数0.1年，范围0至6年）植入了ICD。患者完成了修订版儿童显性焦虑量表、雷诺青少年/儿童抑郁量表、儿童健康问卷-87以及对ICD的担忧量表。家长完成了家庭影响量表和儿童健康问卷（CHQ-50）。除颤器严重程度指数评估心脏严重程度。焦虑或抑郁的发生率并未增加，尽管患者似乎表现出对社会认可的更大需求。家长对整体家庭功能的评分与正常样本均值无显著差异。家长报告的CHQ-50总体身体功能得分显著低于美国正常样本的得分，而CHQ-50总体心理社会得分则无显著差异。当被问及孩子的身体功能、社会-身体角色功能和总体健康认知时，照顾者认为他们孩子的生活质量较低。尽管心理社会总体得分、社会情感/行为角色以及孩子的健康对自身的情感影响总体无显著差异，但各子量表均显著低于正常样本。心脏疾病严重程度与焦虑、抑郁、生活质量或家庭功能无显著关联。然而，在焦虑、抑郁、家庭功能和生活质量的测量指标之间发现了显著关联。总体而言，大多数患有ICD的儿科患者似乎是一群适应能力强的年轻人。他们的生活质量与其焦虑和抑郁情绪以及家庭功能的相关性，比与心脏疾病严重程度的相关性更强。
