Sanna Tommaso, Fedele Francesco, Genuini Igino, Puglisi Andrea, Azzolini Paolo, Altamura Giuliano, Lobianco Francesco, Ruzzolini Matteo, Perna Francesco, Micò Mirco, Roscio Giancarlo, Mottironi Pierluigi, Saraceni Carlo, Pistolese Michele, Bellocci Fulvio
Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
Am Heart J. 2006 Oct;152(4):685.e1-7. doi: 10.1016/j.ahj.2006.07.008.
Out-of-hospital cardiac arrest occurs at home in 65-80% of cases and is often witnessed. We designed a study to explore the feasibility of a home defibrillation program (a) evaluating the retention of cardiopulmonary resuscitation and automated external defibrillators (AED) use skills (BLSD) (b) assessing the impact on anxiety, depression, and quality of life and (c) recording the critical issues emerging from program implementation.
Thirty-three post-myocardial infarction patients and their 56 relatives received BLSD training and an AED. Assessment of BLSD skills, levels of anxiety, and depression and quality of life were scheduled every 3 months for 1 year or until a common stopping date.
Overall BLSD score was 26 +/- 3 at baseline vs. 22 +/- 5 at 3 months (P < .0001), 21 +/- 6 at 6 months (P < .0001), 22 +/- 4 at 9 months (P < .0001) and 23 +/- 5 at 12 months (P = .001). Conversely, the BLSD component AED use" remained stable throughout the study. Quality of life, anxiety, and depression scores remained constant. Compliance to BLSD retraining sessions and AEDs checks decreased over time and was influenced by a concomitant clinical appointment.
BLSD performance of families of post-myocardial infarction patients decreases over time, even though the ability to operate AEDs appears to be the least affected component. Compliance with retraining sessions and AED checks declines over time and is improved if they are combined with clinical appointments. The implementation of a home defibrillation program does not affect anxiety, depression, or the quality of life.
65% - 80%的院外心脏骤停发生在家中，且通常有目击者。我们设计了一项研究，以探讨家庭除颤计划的可行性，该计划旨在(a)评估心肺复苏术和自动体外除颤器（AED）使用技能（BLSD）的保持情况；(b)评估对焦虑、抑郁和生活质量的影响；(c)记录计划实施过程中出现的关键问题。
33名心肌梗死后患者及其56名亲属接受了BLSD培训并获得一台AED。在1年时间内或直至共同停止日期，每3个月对BLSD技能、焦虑和抑郁水平以及生活质量进行评估。
基线时总体BLSD评分为26±3，3个月时为22±5（P <.0001），6个月时为21±6（P <.0001），9个月时为22±4（P <.0001），12个月时为23±5（P =.001）。相反，“BLSD组件AED使用”在整个研究过程中保持稳定。生活质量、焦虑和抑郁评分保持不变。随着时间推移，对BLSD再培训课程和AED检查的依从性下降，且受到同时进行的临床预约的影响。
心肌梗死后患者家属的BLSD表现随时间下降，尽管操作AED的能力似乎是受影响最小的部分。随着时间推移，对再培训课程和AED检查的依从性下降，如果将其与临床预约相结合则会得到改善。家庭除颤计划的实施不会影响焦虑、抑郁或生活质量。
