Habibović Mirela, Denollet Johan, Cuijpers Pim, van der Voort Pepijn H, Herrman Jean-Paul, Bouwels Leon, Valk Suzanne D A, Alings Marco, Theuns Dominic A M J, Pedersen Susanne S
CoRPS-Department of Medical and Clinical Psychology.
Department of Clinical, Neuro and Developmental Psychology, Vrije University Amsterdam.
Health Psychol. 2017 Apr;36(4):392-401. doi: 10.1037/hea0000451. Epub 2017 Feb 13.
Sudden cardiac arrest caused by cardiac arrhythmias is 1 of the leading causes of death worldwide. Implantable cardioverter defibrillators (ICDs) are considered as standard care for patients with increased risk of arrhythmias. However, 1 in 4 ICD patients experiences psychological distress post-ICD implantation. The WEB-based distress management program for ICD patients (WEBCARE) was developed to mitigate anxiety and depression and enhance health-related quality of life in ICD patients. This study investigates the 6- and 12-months outcomes.
A total of 289 consecutive ICD patients from 6 referral hospitals in the Netherlands were randomized to either the WEBCARE (n = 146) or usual care (n = 143) group. Patients in the WEBCARE group received an online, 12-weeks fixed, 6 lesson behavioral treatment based on problem solving therapy. Patients in the usual care group receive care as usual.
Current findings show no significant difference on anxiety, depression or quality of life between the WEBCARE and Usual Care group at 6- and 12-months postimplantation.
In this clinical trial of a Web-based behavioral intervention for ICD patients, the Web-based treatment was not superior to usual care on the long-term regarding patient reported outcomes. Future studies are warranted to examine the applicability of blended-care models and focus on further personalizing the program in order to increase adherence and improve outcomes. (PsycINFO Database Record
心律失常导致的心脏骤停是全球主要死因之一。植入式心脏复律除颤器（ICD）被视为心律失常风险增加患者的标准治疗手段。然而，四分之一的ICD患者在植入ICD后会出现心理困扰。基于网络的ICD患者困扰管理项目（WEBCARE）旨在减轻ICD患者的焦虑和抑郁，并提高其与健康相关的生活质量。本研究调查了6个月和12个月的结果。
来自荷兰6家转诊医院的289例连续ICD患者被随机分为WEBCARE组（n = 146）或常规治疗组（n = 143）。WEBCARE组患者接受基于问题解决疗法的为期12周、固定6节课程的在线行为治疗。常规治疗组患者接受常规护理。
目前的研究结果显示，在植入后6个月和12个月时，WEBCARE组和常规护理组在焦虑、抑郁或生活质量方面没有显著差异。
在这项针对ICD患者的基于网络的行为干预临床试验中，就患者报告的结果而言，基于网络的治疗在长期效果上并不优于常规护理。未来有必要开展研究，以检验混合护理模式的适用性，并专注于进一步个性化该项目，以提高依从性并改善结果。（PsycINFO数据库记录）
