Asif Irfan M, Price David, Fisher Leslee A, Zakrajsek Rebecca A, Larsen Leslie K, Raabe Johannes J, Bejar Matthew P, Rao Ashwin L, Harmon Kimberly G, Drezner Jonathan A
Department of Family Medicine, Greenville Health System, University of South Carolina Greenville School of Medicine, Greenville, SC, USA.
Department of Family Medicine, Carolinas Medicine Center, Charlotte, NC, USA.
J Electrocardiol. 2015 May-Jun;48(3):298-310. doi: 10.1016/j.jelectrocard.2014.12.018. Epub 2015 Jan 3.
Sudden cardiac death (SCD) in sports is a tragic event. Pre-participation cardiovascular screening is required before participation in high school and college athletic programs and is universally endorsed by major medical societies. The medical impact of a diagnosis may be life-saving; however, the detection of disease should not be the sole endpoint of care. Physicians have an obligation to attend to both the medical and psychological well-being of their patients.
To determine the psychological impact of being diagnosed with cardiac disease in young competitive athletes.
Athletes diagnosed with cardiac conditions were recruited to participate in a semi-structured interview, which was analyzed by sport psychology experts using qualitative research. Individuals shared reactions and experiences regarding diagnosis, lifestyle implications, coping strategies, major concerns, and overall impact on psychosocial functioning.
Young competitive athletes from across the United States.
25 athletes (52% male, 80% Caucasian, median age 17.7) participated. Diagnoses included: 5 hypertrophic cardiomyopathy, 8 Wolff Parkinson White, 4 long QT syndrome, 3 atrial septal defect, 2 supraventricular tachycardia, and 3 other.
Interviews were analyzed using consensual qualitative research (CQR) to identify domains, categories, and core ideas.
Athletes progressed through 4 stages of psychological impact including: 1) immediate reactions and challenge to athlete identity, 2) grief/coping, 3) adaptation, and 4) acceptance. Risk factors for increased psychological morbidity included: higher level of competition, permanent disqualification from sports, persistent reminders (e.g. daily medication, monitoring heart rate during activity), and unanticipated outcomes (e.g. failed procedures). Those undergoing simple corrective procedures came to terms with their diagnosis quickly with little impact on daily life. Few athletes described emotional support mechanisms provided by medical programs. Diagnosis often led to new goals such as mentoring or coaching. All athletes diagnosed through advanced cardiovascular screening stated they would repeat the process.
Athletes diagnosed with cardiac disease represent an emotionally vulnerable population and experience 4 stages of psychological adjustment not previously described. This proposed model of psychological impact should be used to develop improved support mechanisms, awareness, and education to assist athletes diagnosed with serious or potentially lethal cardiac disease.
运动性心源性猝死（SCD）是一个悲剧性事件。参加高中和大学体育项目前需要进行心血管筛查，这得到了主要医学协会的普遍认可。诊断的医学影响可能会挽救生命；然而，疾病检测不应是护理的唯一终点。医生有义务关注患者的身心健康。
确定年轻竞技运动员被诊断患有心脏病后的心理影响。
招募被诊断患有心脏病的运动员参加半结构化访谈，由运动心理学专家采用定性研究方法进行分析。参与者分享了关于诊断、生活方式影响、应对策略、主要担忧以及对心理社会功能总体影响的反应和经历。
来自美国各地的年轻竞技运动员。
25名运动员（52%为男性，80%为白种人，中位年龄17.7岁）参与。诊断包括：5例肥厚型心肌病、8例预激综合征、4例长QT综合征、3例房间隔缺损、2例室上性心动过速和3例其他疾病。
采用共识定性研究（CQR）对访谈进行分析，以确定领域、类别和核心观点。
运动员经历了心理影响的4个阶段，包括：1）对运动员身份的即时反应和挑战；2）悲伤/应对；3）适应；4）接受。心理发病率增加的风险因素包括：竞争水平较高、被永久取消体育资格、持续提醒（如每日服药、活动时监测心率）以及意外结果（如手术失败）。接受简单矫正手术的患者很快就接受了诊断，对日常生活影响很小。很少有运动员描述医疗项目提供的情感支持机制。诊断通常会带来新的目标，如指导或教练工作。所有通过高级心血管筛查被诊断的运动员表示他们会重复这个过程。
被诊断患有心脏病的运动员是一个情感上脆弱的群体，经历了此前未描述过的4个心理调整阶段。这种提出的心理影响模型应用于开发更好的支持机制、提高认识和开展教育，以帮助被诊断患有严重或潜在致命心脏病的运动员。
