Kimberly A. Udlis, PhD, FNP-BC Assistant Professor/Assistant Director, Advanced Practice Nursing, Graduate Program, College of Nursing, University of Wisconsin Oshkosh.
J Cardiovasc Nurs. 2013 Nov-Dec;28(6):E65-73. doi: 10.1097/JCN.0b013e31827b9789.
The impact of implantable cardioverter defibrillator (ICD) technology on the quality of life (QOL) experienced by recipients has been a major focus of recent research. Numerous studies have found psychological distress to be important in determining QOL in persons receiving ICDs, yet the source of psychological distress is not well understood.
The aim of this study was to determine the impact of technology dependency on psychological outcomes in ICD recipients.
With the use of a cross-sectional design, 161 ICD recipients from 1 device clinic were mailed self-administered questionnaires, including the Dependency on Technology Scale, Brief Illness Perception Questionnaire, Florida Shock Anxiety Scale, Florida Patient Acceptance Survey, and Short Form-12 (SF-12). Hierarchical multiple regressions and analyses of variance were performed.
The final sample size was 101 participants. Mean (SD) age was 68 (13) years; 72% of the participants were men, 99% were white, and 30% reported receiving a shock(s). A total of 80% reported positive attitudes toward technology dependency; 14%, neutral; and 6%, negative (Dependency on Technology Scale). Illness perceptions were positive (Brief Illness Perception Questionnaire; mean[SD], 34.5 [12.6]), shock anxiety was elevated (Florida Shock Anxiety Scale; mean [SD], 16.5 [6.7]), and device acceptance was good (Florida Patient Acceptance Survey; mean [SD], 74.9 [17.0]). Physical health QOL was low (SF-12; mean [SD], 38.6 [11.3]) and mental health QOL was moderate (SF-12; mean [SD], 50.6 [10.0]). Attitudes toward technology dependency significantly accounted for the variance seen in device acceptance and mental health QOL beyond age, gender, number of shocks, illness perceptions, and shock anxiety by 5.7% (P = .001) and 3.3% (P = .04), respectively. Significant differences were seen in device acceptance between those with negative and neutral attitudes (P = .001) and those with negative and positive attitudes (P < .001) and in shock anxiety and mental health QOL between those with negative and those with positive attitudes (P < .001).
Attitudes toward technology dependency is significantly associated with psychological outcomes and may explain the psychological distress in some ICD recipients. Degree of positivity toward technology dependency influences these outcomes. Research evaluating attitudes toward technology dependency and testing of interventions focusing on these attitudes is warranted.
植入式心脏复律除颤器（ICD）技术对接受者生活质量（QOL）的影响一直是近期研究的重点。许多研究发现，心理困扰在接受 ICD 的人群中对 QOL 很重要，但心理困扰的来源尚不清楚。
本研究旨在确定技术依赖性对 ICD 接受者心理结果的影响。
采用横断面设计，对 1 家设备诊所的 161 名 ICD 接受者邮寄了自我管理问卷，包括依赖技术量表、简要疾病感知问卷、佛罗里达震惊焦虑量表、佛罗里达患者接受度调查和健康调查简表 12 项（SF-12）。进行了分层多元回归和方差分析。
最终样本量为 101 名参与者。平均（SD）年龄为 68（13）岁；72%的参与者为男性，99%为白人，30%报告接受过电击（s）。共有 80%的人对技术依赖持积极态度；14%持中立态度；6%持消极态度（依赖技术量表）。疾病认知呈阳性（简要疾病认知问卷；平均值[标准差]，34.5[12.6]），震惊焦虑程度升高（佛罗里达震惊焦虑量表；平均值[标准差]，16.5[6.7]），设备接受程度良好（佛罗里达患者接受度调查；平均值[标准差]，74.9[17.0]）。身体健康质量较低（SF-12；平均值[标准差]，38.6[11.3]），心理健康质量中等（SF-12；平均值[标准差]，50.6[10.0]）。对技术依赖的态度在考虑年龄、性别、电击次数、疾病认知和震惊焦虑后，分别对设备接受度和心理健康质量的方差有 5.7%（P=.001）和 3.3%（P=.04）的显著解释作用。在设备接受度方面，对技术持消极和中立态度的患者与对技术持消极和积极态度的患者之间存在显著差异（P=.001），在震惊焦虑和心理健康质量方面，对技术持消极态度的患者与对技术持积极态度的患者之间存在显著差异（P<.001）。
对技术依赖的态度与心理结果显著相关，可能解释了某些 ICD 接受者的心理困扰。对技术的积极程度影响这些结果。需要评估对技术依赖的态度的研究，并测试针对这些态度的干预措施。
