Kim Jin Shil, Pressler Susan J, Welch Janet L, Damush Teresa, Sloan Rebecca S, Wu Jingwei, Groh William J
Michigan State University College of Nursing, East Lansing, MI 48824, USA.
J Cardiovasc Nurs. 2009 Sep-Oct;24(5):398-409. doi: 10.1097/JCN.0b013e3181aa216c.
Patients with implantable cardioverter-defibrillators (ICDs) face problems in physical function, but little is known about how mastery predicts physical function over time.
The primary purpose of this study was to examine the influence of mastery (assessed at baseline) on physical function (observed distance walked and perceived function) over 12 months among ICD patients. Secondary purposes were to (1) examine the influence of aging, in interaction with mastery, on physical function and (2) determine predictors of 12-month physical function.
The ICD patients (N = 122; 75% men; 88% white; mean age, 65 years) completed the baseline interviews; 100 patients completed the 12-month interviews. Repeated-measures 1-way analyses of variance were used to examine the influence of mastery and the interaction of mastery and aging on physical function over 12 months. Multiple regression analyses were conducted to determine predictors of 12-month physical function.
The ICD patients with higher mastery had better walk distances than those with lower mastery; and walk distances were improved over 12 months, but only in those with lower mastery (F = 5.40, P = .02). The ICD patients with higher mastery had better perceived physical function than those with lower mastery (F = 25.57, P < .0001), but those with both lower and higher mastery did not show significant improvement. Neither significant interaction of aging and mastery on physical function nor predictors of walk distances were found. Baseline depression significantly predicted 12-month perceived physical function (F = 8.94, P = .0042).
The ICD patients with lower mastery had considerable impairments in physical function compared with those with higher mastery over time. Depression is more likely to predict perceived physical function. Further prospective studies are needed to validate these findings in a larger sample and develop interventions to improve physical impairment in ICD patients.
植入式心脏复律除颤器（ICD）患者面临身体功能方面的问题，但对于掌握程度如何随时间推移预测身体功能，人们了解甚少。
本研究的主要目的是考察ICD患者在12个月期间掌握程度（在基线时评估）对身体功能（观察到的行走距离和感知功能）的影响。次要目的是：（1）考察年龄增长与掌握程度相互作用对身体功能的影响；（2）确定12个月身体功能的预测因素。
ICD患者（N = 122；75%为男性；88%为白人；平均年龄65岁）完成了基线访谈；100名患者完成了12个月的访谈。采用重复测量单因素方差分析来考察掌握程度以及掌握程度与年龄增长的交互作用对12个月期间身体功能的影响。进行多元回归分析以确定12个月身体功能的预测因素。
掌握程度较高的ICD患者比掌握程度较低的患者行走距离更远；行走距离在12个月内有所改善，但仅在掌握程度较低的患者中如此（F = 5.40，P = .02）。掌握程度较高的ICD患者比掌握程度较低的患者感知到的身体功能更好（F = 25.57，P < .0001），但掌握程度低和高的患者均未显示出显著改善。未发现年龄增长与掌握程度对身体功能的显著交互作用，也未发现行走距离的预测因素。基线抑郁显著预测了12个月的感知身体功能（F = 8.94，P = .0042）。
随着时间推移，与掌握程度较高的ICD患者相比，掌握程度较低的患者在身体功能方面有相当大的损害。抑郁更有可能预测感知到的身体功能。需要进一步的前瞻性研究在更大样本中验证这些发现，并制定干预措施以改善ICD患者的身体损害。
Zotero 插件