对植入式心脏复律除颤器治疗的态度：丹麦医疗保健专业人员的全国性调查。

Attitudes towards implantable cardioverter-defibrillator therapy: a national survey in Danish health-care professionals.

机构信息

Department of Cardiology, Aarhus University Hospital, Brendstrupgaardsvej 100, Aarhus N, Skejby, Denmark.

出版信息

Europace. 2011 May;13(5):663-7. doi: 10.1093/europace/euq404. Epub 2010 Dec 10.

DOI:10.1093/europace/euq404

PMID:21148663

Abstract

AIMS

The aim of this study was to examine health-care professionals attitudes towards implantable cardioverter-defibrillator (ICD) therapy and issues discussed with patients.

METHODS AND RESULTS

Survey of 209 health-care professionals providing specialized treatment and care of ICD patients at the five implanting centres in Denmark. Questions pertained to gender, age, years of experience within the field, knowledge of the ongoing critical debate on ICD therapy, and personal experience with ICD treatment, and/or sudden cardiac arrest within family and/or friends. Of all participants, 185 (88.5%) completed the survey. Physicians spent less time informing patients about ICD treatment prior to implantation (mean min = 17.7 ± 11.2 vs. 28.6 ± 19.4; P < 0.001). They were more likely to discuss clinical issues but less likely to discuss psychosocial issues with patients compared with non-physicians. Physicians were less likely to believe that their personal attitude towards ICD treatment has no influence on how they deal professionally with patients (27.8 vs. 43.6%; P = 0.04). Physicians and non-physicians were equally positive towards ICD therapy as primary prophylaxis in ischaemic cardiomyopathy (87.6 vs. 82.1%; P = 0.40) but not in non-ischaemic cardiomyopathy (57.3 vs. 83.9%; P < 0.001). Physicians were more positive towards ICD therapy as secondary prophylaxis (98.9 vs. 84.2%; P = 0.001) compared with non-physicians.

CONCLUSIONS

Physicians focus on clinical rather than psychosocial issues when discussing ICD treatment with candidate patients. At the same time, physicians are more aware that their attitude towards ICD treatment may influence how they deal professionally with patients compared with non-physicians.

摘要

目的

本研究旨在调查医疗保健专业人员对植入式心脏复律除颤器（ICD）治疗的态度以及与患者讨论的问题。

方法和结果

对丹麦五个植入中心的 209 名专门治疗和护理 ICD 患者的医疗保健专业人员进行了调查。问题涉及性别、年龄、该领域工作年限、对正在进行的 ICD 治疗关键辩论的了解、个人 ICD 治疗经验、以及在家庭和/或朋友中是否经历过心脏骤停。在所有参与者中，185 人（88.5%）完成了调查。与非医师相比，医生在植入前告知患者 ICD 治疗的时间更少（平均最小=17.7±11.2 与 28.6±19.4；P<0.001）。他们更倾向于讨论临床问题，但与非医师相比，更倾向于讨论心理社会问题。与非医师相比，医生更不可能认为他们对 ICD 治疗的个人态度对他们如何专业地与患者打交道没有影响（27.8%与 43.6%；P=0.04）。医生和非医生对 ICD 治疗作为缺血性心肌病的一级预防同样持积极态度（87.6%与 82.1%；P=0.40），但对非缺血性心肌病则不然（57.3%与 83.9%；P<0.001）。与非医师相比，医生对 ICD 治疗作为二级预防更持积极态度（98.9%与 84.2%；P=0.001）。