Department of Psychology and Cardiovascular Sciences, East Carolina University, Greenville, North Carolina, USA.
Am J Cardiol. 2011 Apr 1;107(7):1023-7. doi: 10.1016/j.amjcard.2010.11.027. Epub 2011 Jan 20.
Psychosocial and quality-of-life (QOL) outcomes in adult patients with implantable cardioverter-defibrillators (ICDs) are well studied. Minimal research exists regarding pediatric adjustment, despite a potentially more challenging adjustment process. The purpose of the present study was to examine psychosocial and QOL functioning of pediatric ICD patients from patient and parent self-reports. Children and primary caregiver dyads from several university hospitals were analyzed using the PedsQL, the Device Severity Index, the ICD and Avoidance Survey, and demographic information. Sixty children (25 female, 35 male) were enrolled. The present pediatric sample reported lower psychosocial and physical QOL scores than healthy children's normative scores. In comparison with a sample of chronically ill children, pediatric ICD patients reported lower physical QOL. Parent-observed QOL reports revealed lower psychosocial and physical QOL than parent-observed healthy norms and lower psychosocial and physical QOL than chronically ill norms. There were no QOL differences by ICD shocks or medical severity. Female patients reported lower psychosocial, physical, and cardiac QOL scores. Children reported better QOL than parent observations on psychosocial and physical health. Finally, 84.7% of children reported avoidance behaviors since ICD implantation, with female children avoiding places more than male children. In conclusion, pediatric ICD patients are comparable to children with other chronic illnesses with the exception of lower physical QOL. Similar to adult samples, female children reported poorer QOL and were more likely to engage in avoidance behaviors. Patients indicated better QOL perceptions than their parents' reports. ICD discharges and medical severity did not negatively affect QOL.
成人心律转复除颤器（ICD）患者的心理社会和生活质量（QOL）结局已有大量研究。尽管儿童的适应过程可能更具挑战性，但关于儿科调整的研究很少。本研究的目的是通过患者和家长的自我报告来检查儿科 ICD 患者的心理社会和 QOL 功能。使用 PedsQL、Device Severity Index、ICD 和回避调查以及人口统计学信息，对来自几家大学医院的儿童和主要照顾者对进行了分析。共有 60 名儿童（25 名女性，35 名男性）入组。本儿科样本报告的心理社会和身体 QOL 评分低于健康儿童的正常评分。与一组慢性疾病儿童相比，儿科 ICD 患者报告的身体 QOL 较低。家长观察到的 QOL 报告显示，心理社会和身体 QOL 低于家长观察到的健康正常水平，也低于慢性疾病正常水平。ICD 电击或医疗严重程度没有 QOL 差异。女性患者报告的心理社会、身体和心脏 QOL 评分较低。与家长的观察相比，儿童报告的心理社会和身体健康状况较好。最后，84.7%的儿童报告自 ICD 植入后出现回避行为，女性儿童比男性儿童更回避某些地方。总之，儿科 ICD 患者与其他慢性疾病患儿相当，除了身体 QOL 较低。与成年患者相似，女性儿童报告的 QOL 较差，更有可能回避某些行为。患者的 QOL 感知优于家长的报告。ICD 放电和医疗严重程度并未对 QOL 产生负面影响。
