Habibović Mirela, Pedersen Susanne S, van den Broek Krista C, Denollet Johan
CoRPS-Department of Medical and Clinical Psychology, Tilburg University, 90153, 5000 LE Tilburg, The Netherlands.
CoRPS-Department of Medical and Clinical Psychology, Tilburg University, 90153, 5000 LE Tilburg, The Netherlands Department of Cardiology, Thoraxcenter, Erasmus Medical Center, 2040, 3000 CA Rotterdam, The Netherlands Department of Psychology, University of Southern Denmark, DK-5230 Odense, Denmark Department of Cardiology, Odense University Hospital, DK-5000 Odense, Denmark
Europace. 2014 Jul;16(7):1022-7. doi: 10.1093/europace/euu006. Epub 2014 Mar 3.
Patient treatment expectations may affect cardiac outcomes; however, till date, no validated instruments have been developed to monitor treatment expectations in patients with an implantable cardioverter-defibrillator (ICD). This study evaluates the predictive value of the newly developed 10-item EXPECtations Towards ICD therapy (EXPECT-ICD) in relation to anxiety, depression, and ICD related concerns 3 months post-implant.
Consecutive implanted ICD patients were included as part of the WEB-based distress management programme for ICD patients (WEBCARE) trial from six Dutch referral hospitals. The patients completed the baseline questionnaires briefly after ICD implantation. Information on clinical variables was captured from the patients' medical records. Patients' treatment expectations as assessed with the EXPECT-ICD questionnaire could best be represented with a two-factor model involving both negative (α = 0.84) and positive expectations (α = 0.77) with a score range of 0-20 for each factor. Negative treatment expectations were associated with higher levels of anxiety (β = 0.443; P < 0.001), depression (β = 0.506; P < 0.001), and ICD concerns (β = 0.428; P < 0.001) 3 months post-implant after controlling for demographic and clinical factors. Positive expectations were not related to any of the distress outcomes.
Negative expectations were associated with anxiety, depression, and ICD concerns 3 months post-implant. The current findings indicate that the EXPECT-ICD scale is a reliable, valid, and disease-specific measure of the treatment expectations in ICD patients. Future research needs to investigate whether addressing the patients' expectations might improve the outcome and the subjective well-being of ICD patients.
患者的治疗期望可能会影响心脏疾病的治疗结果；然而，迄今为止，尚未开发出经过验证的工具来监测植入式心脏复律除颤器（ICD）患者的治疗期望。本研究评估了新开发的包含10个条目的ICD治疗期望量表（EXPECT-ICD）对植入后3个月患者焦虑、抑郁及ICD相关担忧的预测价值。
连续纳入来自六家荷兰转诊医院的植入ICD患者，作为基于网络的ICD患者痛苦管理项目（WEBCARE）试验的一部分。患者在ICD植入后不久完成基线问卷调查。从患者病历中获取临床变量信息。用EXPECT-ICD问卷评估的患者治疗期望，最好用一个双因素模型来表示，该模型包括消极期望（α = 0.84）和积极期望（α = 0.77），每个因素的得分范围为0至20分。在控制了人口统计学和临床因素后，消极治疗期望与植入后3个月时更高水平的焦虑（β = 0.443；P < 0.001）、抑郁（β = 0.506；P < 0.001）和ICD相关担忧（β = 0.428；P < 0.001）相关。积极期望与任何痛苦结果均无关联。
消极期望与植入后3个月时的焦虑、抑郁和ICD相关担忧有关。目前的研究结果表明，EXPECT-ICD量表是一种可靠、有效且针对特定疾病的ICD患者治疗期望测量工具。未来的研究需要调查解决患者期望是否可能改善ICD患者的治疗结果和主观幸福感。
