Aqeel Masooma, Shafquat Azam, Salahuddin Nawal
Department of Medicine, The Aga Khan University Hospital, Stadium Road, Karachi, Pakistan.
BMC Cardiovasc Disord. 2008 Nov 14;8:31. doi: 10.1186/1471-2261-8-31.
Cardiac pacing is a recognized and widely used treatment for patients presenting with bradycardia. Physicians expect patients to return to normal activities almost immediately post implantation. However, patients themselves may perceive interference to pacemaker function by various routine activities and devices, and hence continue to lead restricted, disabled lives. The aim of this study is to determine if routine activities are perceived by pacemaker patients to interfere with their device function.
A descriptive cross sectional survey was carried out on consecutive patients at the pacemaker clinic at a public hospital in Karachi, Pakistan. A 47-question tool was developed and tested. Patients' perceptions of safety of performing various routine activities, along with socio-demographic data were recorded.
The final sample included 93 adult patients (45% males). 41% were illiterate. 77.4% recalled receiving counselling at implantation, predominantly from the implanting physician and house staff. A considerable proportion of patients considered many routine activities unsafe including driving automobiles (28%), passing through metal detectors (31%), bending over (37%), and sleeping on the side of the pacemaker (30%). Also considered unsafe were operation of household appliances--TV/VCR (television/video cassette recorders) (53%), irons (55%)) and electrical wall switches (56%). For nearly all variables neither literacy nor history of counselling improved incorrect perceptions.
This study shows that our pacemaker patients perceive many routine activities as unsafe, potentially leading to disabling life style modifications. The tremendous investment in pacemaker technology to improve patient performance is not going to pay dividends if patients continue to remain disabled due to incorrect perceptions. Further studies are required to determine the reasons for these misperceptions, and to determine if these problems also exist in, and hinder, other patient populations.
心脏起搏是治疗心动过缓患者的一种公认且广泛应用的方法。医生期望患者在植入起搏器后几乎能立即恢复正常活动。然而，患者自身可能会感觉到各种日常活动和设备会干扰起搏器功能，因此继续过着受限、失能的生活。本研究的目的是确定起搏器患者是否认为日常活动会干扰其设备功能。
在巴基斯坦卡拉奇一家公立医院的起搏器诊所，对连续就诊的患者进行了一项描述性横断面调查。开发并测试了一个包含47个问题的工具。记录患者对进行各种日常活动安全性的认知以及社会人口统计学数据。
最终样本包括93名成年患者（45%为男性）。41%为文盲。77.4%的患者回忆起在植入时接受过咨询，主要来自植入医生和住院医生。相当一部分患者认为许多日常活动不安全，包括驾驶汽车（28%）、通过金属探测器（31%）、弯腰（37%）以及在起搏器一侧睡觉（30%）。还认为不安全的有家用电器操作——电视/录像机（53%）、熨斗（55%）和墙壁电开关（56%）。对于几乎所有变量，无论是文盲状态还是咨询史都未能改善错误认知。
本研究表明，我们的起搏器患者认为许多日常活动不安全，这可能导致生活方式受限。如果患者因错误认知而持续失能，那么在起搏器技术上的巨大投入将无法带来益处。需要进一步研究以确定这些错误认知的原因，以及这些问题是否也存在于其他患者群体中并对其造成阻碍。
