School of Healthcare, University of Leeds, UK.
Eur J Cardiovasc Nurs. 2012 Sep;11(3):313-21. doi: 10.1016/j.ejcnurse.2011.06.010. Epub 2012 Apr 4.
While randomised, controlled trials have established the efficacy of the implantable cardioverter defibrillator (ICD) for primary and secondary prevention of life threatening arrhythmias, psychosocial responses remain complex and poorly understood, especially across Europe. There appears to be a greater need to understand differences in the experience of men and women.
The aim of this prospective study was to explore differences in psychosocial adjustment over a 12 month period following ICD implantation.
Fourteen female and thirty three male device recipients completed a series of questionnaires over a 12 month period. Instruments included a generic and an ICD specific Quality of Life (QOL) measure and the state-trait anxiety inventory.
Women reported higher levels of anxiety than men at discharge but over time demonstrated a significant improvement such that at 4, 8 and 12 months men were more anxious. Women reported significantly poorer emotional wellbeing at discharge, however by 12 months this was significantly improved with no difference in the perceptions held by men and women. Women consistently across the 12 months worried more than men about the impact of the device on appearance.
This study confirmed that most individuals adjust positively to the ICD during the first 12 months. Some gender differences in adjustment were evident. Further studies across Europe are warranted to establish gender specific interventions to support men and women as they adapt to life with ICD implants.
虽然随机对照试验已经证实了植入式心脏复律除颤器（ICD）在预防危及生命的心律失常方面的有效性，无论是用于一级预防还是二级预防，但患者的心理社会反应仍然很复杂，且了解甚少，尤其是在欧洲。似乎更需要了解男性和女性在体验方面的差异。
本前瞻性研究旨在探讨 ICD 植入后 12 个月期间心理社会适应方面的差异。
14 名女性和 33 名男性设备接受者在 12 个月的时间内完成了一系列问卷。使用的工具包括通用和 ICD 特定的生活质量（QOL）量表以及状态-特质焦虑量表。
女性在出院时的焦虑水平高于男性，但随着时间的推移，她们的焦虑水平显著改善，以至于在 4、8 和 12 个月时男性的焦虑程度更高。女性在出院时的情绪健康状况明显较差，但到 12 个月时，这种情况明显改善，男性和女性的认知没有差异。女性在 12 个月的时间里一直比男性更担心设备对外观的影响。
本研究证实，大多数人在 ICD 植入后的头 12 个月内会积极适应。在适应方面存在一些性别差异。需要在整个欧洲进行进一步的研究，以确定针对男性和女性的特定干预措施，以支持他们适应 ICD 植入后的生活。
