Department of Psychology, University of Southern Denmark, Campusvej 55, DK-5230 Odense M, Denmark.
Department of Cardiology, Odense University Hospital, Odense, Denmark.
Europace. 2017 Jun 1;19(6):983-990. doi: 10.1093/europace/euw109.
The clinical management and care of patients with an implantable cardioverter defibrillator (ICD) has shifted from face-to-face in-clinic visits to remote monitoring. Reduced interactions between patients and healthcare professionals may impede patients' transition to adapting post-implant. We examined patients' needs and preferences for information provision and care options and overall satisfaction with treatment.
Patients implanted with a first-time ICD or defibrillator with cardiac resynchronization therapy (n = 389) within the last 2 years at Odense University Hospital were asked to complete a purpose-designed and standardized set of questionnaires. The level of satisfaction with information provision was high; only 13.1% were dissatisfied. Psychological support for patients (39.9%), their relatives (43.1%), and deactivation of the ICD towards end of life (47.8%) were among the top five topics that patients reported to have received no information about. The top five care options that patients had missed were talking to the same healthcare professional (75.2%), receiving ongoing feedback via remote monitoring (61.1%), having a personal conversation with a staff member 2-3 weeks post-implant (59.6%), having an exercise tolerance test (52.5%), and staff asking how patients felt while hospitalized (50.4%). Patients with a secondary prevention indication and cardiac arrest survivors had specific needs, including a wish for a psychological consult post-discharge.
Despite a high satisfaction level with information provision, particular topics are not broached with patients (e.g. device activation) and patients have unmet needs that are not met in current clinical practice.
植入式心脏复律除颤器 (ICD) 的临床管理和护理已从面对面的门诊就诊转变为远程监测。患者与医疗保健专业人员之间的互动减少可能会阻碍患者适应植入后的转变。我们研究了患者对信息提供和护理方案的需求和偏好，以及对治疗的总体满意度。
在奥登塞大学医院植入首次 ICD 或带心脏再同步治疗 (CRT) 的 ICD 的患者（n = 389）在过去 2 年内被要求完成一套专门设计和标准化的问卷。信息提供的满意度水平很高；只有 13.1%的患者不满意。患者（39.9%）、其亲属（43.1%）和 ICD 接近生命终点时的去激活（47.8%）的心理支持是患者报告没有收到信息的前五个主题之一。患者错过的前五个护理方案是与同一医疗保健专业人员交谈（75.2%）、通过远程监测持续获得反馈（61.1%）、植入后 2-3 周与工作人员进行个人交谈（59.6%）、进行运动耐量测试（52.5%）和工作人员询问患者住院期间的感受（50.4%）。具有二级预防指征和心脏骤停幸存者的患者有特殊需求，包括希望在出院后进行心理咨询。
尽管患者对信息提供的满意度水平较高，但有些特定主题并未与患者探讨（例如设备激活），并且患者存在当前临床实践无法满足的未满足需求。
