Jongejan N, Timmermans I, Elders J, Meijer K, Meine M, Doevendans P A, Versteeg H, Tuinenburg A E
Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
CoRPS-Center of Research on Psychology in Somatic Diseases, Department of Medical Psychology, Tilburg University, Tilburg, The Netherlands.
Neth Heart J. 2018 Feb;26(2):69-75. doi: 10.1007/s12471-017-1067-z.
Dutch patients with an implantable cardioverter defibrillator (ICD) are restricted from driving for two months after implantation or shocks. This requires significant lifestyle adjustments and is one of the primary concerns of ICD patients. Previous studies indicated that compliance with the driving restrictions is poor, but insight in socio-demographic, clinical and psychological factors associated with compliance is limited. Hence, this study aimed to explore compliance with the driving restrictions and associated factors in a large sample of Dutch ICD patients.
Dutch ICD patients (N = 313) completed an elaborative set of questionnaires at time of implantation and at four months after implantation, assessing socio-demographic, psychological and driving-related characteristics. Clinical data were collected from the patients' medical records.
A substantial subgroup (28%) of the patient sample (median age 64 (interquartile range = 55-71), 81% male) reported to have been noncompliant with the driving restrictions. Univariate analysis indicated that noncompliant patients more often considered refusing the ICD due to the restrictions, compared to compliant patients (19% versus 10%, p = 0.02). Multivariate analysis showed that the feeling of understanding the reason behind the driving restrictions was associated with better compliance (odds ratio = 2.16, 95% confidence interval 1.02-4.56, p = 0.04). No other socio-demographic, clinical, psychological or driving-related factors were associated with compliance.
A large number of ICD patients does not comply with the driving restrictions after implantation. This study emphasised the importance of the patient's feeling of understanding the reason behind the restrictions.
荷兰植入式心脏复律除颤器（ICD）患者在植入或电击后两个月内被限制驾驶。这需要对生活方式进行重大调整，也是ICD患者主要关心的问题之一。先前的研究表明，对驾驶限制的遵守情况较差，但对与遵守情况相关的社会人口统计学、临床和心理因素的了解有限。因此，本研究旨在探讨大量荷兰ICD患者对驾驶限制的遵守情况及相关因素。
荷兰ICD患者（N = 313）在植入时和植入后四个月完成了一套详尽的问卷，评估社会人口统计学、心理和驾驶相关特征。临床数据从患者病历中收集。
患者样本中的一个相当大的亚组（28%）（中位年龄64岁（四分位间距 = 55 - 71岁），81%为男性）报告未遵守驾驶限制。单因素分析表明，与遵守限制的患者相比，不遵守限制的患者因这些限制而更常考虑拒绝植入ICD（19%对10%，p = 0.02）。多因素分析显示，理解驾驶限制背后原因的感觉与更好的遵守情况相关（优势比 = 2.16，95%置信区间1.02 - 4.56，p = 0.04）。没有其他社会人口统计学、临床、心理或驾驶相关因素与遵守情况相关。
大量ICD患者在植入后不遵守驾驶限制。本研究强调了患者理解限制背后原因的感觉的重要性。
