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植入式心脏复律除颤器患者生活质量和心理困扰的性别差异。

Gender disparities in quality of life and psychological disturbance in patients with implantable cardioverter-defibrillators.

机构信息

Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.

出版信息

Circ J. 2013;77(5):1158-65. doi: 10.1253/circj.cj-12-1116. Epub 2013 Jan 22.

Abstract

BACKGROUND

Implantable cardioverter-defibrillator (ICD) has improved prognosis in fatal arrhythmia and the number of ICD implantations has increased. ICD-related psychological problems and impaired quality of life (QOL), however, have been observed. This study examined whether gender differences exist in QOL and psychological disturbances in ICD patients.

METHODS AND RESULTS

Consecutive outpatients (n=179; mean age, 60.5±15.9 years; 81% male) with ICD implantations completed questionnaires consisting of the Short Form-8 (SF-8), Beck Depression Inventory, Impact of Event Scale-Revised (IES-R), State-Trait Anxiety Inventory, and Worries about ICD. One-way multivariate analysis of variance (MANOVA) showed women to have impaired QOL on the role physical functioning (F15,157=4.57, P<0.05) and bodily pain (F15,157=5.26, P<0.05) subscales of the SF-8. More women reported depression (F15,157=5.37, P<0.05) and worry about ICD than men (F15,157=6.62, P<0.05). Moreover, women also had higher IES-R scores indicating post-traumatic stress disorder (PTSD) than men (F15,157=5.87, P<0.05).

CONCLUSIONS

Women reported poorer QOL on 2 subscales: role physical functioning and bodily pain. There was a significant relationship between gender and depression, worry about ICD, and PTSD, but not for anxiety. Female patients need more psychological interventions following ICD implantation.

摘要

背景

植入式心脏复律除颤器(ICD)改善了致命性心律失常患者的预后,植入 ICD 的患者数量也有所增加。然而,ICD 相关的心理问题和生活质量(QOL)受损已经被观察到。本研究旨在探讨 ICD 患者的 QOL 和心理障碍是否存在性别差异。

方法和结果

连续门诊患者(n=179;平均年龄 60.5±15.9 岁,81%为男性)完成了包括简明健康调查问卷 8 项(SF-8)、贝克抑郁量表、修订后的事件影响量表(IES-R)、状态-特质焦虑量表和对 ICD 的担忧在内的问卷。单因素方差分析(MANOVA)显示,女性在 SF-8 的躯体角色功能(F15,157=4.57,P<0.05)和躯体疼痛(F15,157=5.26,P<0.05)子量表上的 QOL 较差。与男性相比,更多的女性报告了抑郁(F15,157=5.37,P<0.05)和对 ICD 的担忧(F15,157=6.62,P<0.05)。此外,女性的 IES-R 评分也较高,表明患有创伤后应激障碍(PTSD)的比例高于男性(F15,157=5.87,P<0.05)。

结论

女性在躯体角色功能和躯体疼痛两个子量表上报告的 QOL 较差。性别与抑郁、对 ICD 的担忧和 PTSD 显著相关,但与焦虑无关。女性患者在植入 ICD 后需要更多的心理干预。

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