Fritzsche Kurt, Forster Florian, Schweickhardt Axel, Kanwischer Hartmut, Drinkmann Arno, Rabung Sven, Bergmann Günter, Geibel Annette, Herrmann-Lingen Christoph
Department of Psychosomatic Medicine and Psychotherapy, University Hospital Freiburg, Haupstrasse 8, Freiburg, Germany.
Gen Hosp Psychiatry. 2007 Nov-Dec;29(6):526-36. doi: 10.1016/j.genhosppsych.2007.07.003.
The implantable cardioverter defibrillator (ICD) has been proven to prolong the lives of patients with life-threatening ventricular arrhythmia. However, implant recipients must cope with numerous challenges. We studied the effects of specific coping strategies and the adaptability of coping in ICD implant recipients.
This prospective study investigated the subjective well-being and objective disease course in 180 patients with life-threatening cardiac arrhythmias, who were recruited while awaiting implantation of a cardioverter defibrillator. Patients completed well-validated self-assessment questionnaires before implantation (T0), as well as 3 months (T1) and 1 year (T2) after implantation. In addition, cardiological findings were documented.
Depressive coping (range Beta, -0.36 to -0.58) was found to be a stable highly-significant predictor for low emotional well-being and quality of life. Active problem-oriented coping showed small positive influence (range Beta, 0.10 to 0.19). Employing a broad range of coping strategies was predictive of less emotional distress and better quality of life.
Depressive coping is a risk factor for emotional distress and poor quality of life after ICD implantation. Patients with this tendency should be identified early and offered supportive psychotherapy.
植入式心脏复律除颤器（ICD）已被证明可延长危及生命的室性心律失常患者的生命。然而，植入者必须应对众多挑战。我们研究了特定应对策略的效果以及ICD植入者应对方式的适应性。
这项前瞻性研究调查了180名危及生命的心律失常患者的主观幸福感和客观病程，这些患者在等待植入心脏复律除颤器时被招募。患者在植入前（T0）以及植入后3个月（T1）和1年（T2）完成了经过充分验证的自我评估问卷。此外，记录了心脏检查结果。
发现消极应对（β范围为-0.36至-0.58）是情绪幸福感和生活质量低下的稳定且高度显著的预测因素。积极的问题导向应对显示出较小的积极影响（β范围为0.10至0.19）。采用多种应对策略可预测较少的情绪困扰和更好的生活质量。
消极应对是ICD植入后情绪困扰和生活质量差的危险因素。应尽早识别有这种倾向的患者并提供支持性心理治疗。
