Kim JinShil, Park Jin-Kyu, Choi Jiin, Kim Sun Hwa, On Young Keun, Shin Mi-Seung, Choi NaYeon, Heo Seongkum
College of Nursing (Medical campus), Gachon University, Incheon 21936, Korea.
Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea.
J Clin Med. 2020 Jan 22;9(2):307. doi: 10.3390/jcm9020307.
Recipients of implantable cardioverter-defibrillator (ICD) therapy in Western countries often experience distressful physical and psychological adjustments. Sociocultural influences on post-implant recovery are likely; however, evidence from other ethnic/cultural backgrounds is lacking. This study aimed to examine the changes in physical function and psychological distress (anxiety and depressive symptoms) from pre-implant to one, six, and 12 months post-implant in Korean patients undergoing ICD therapy. A total of 34 patients underwent pre- to post-implant longitudinal assessments of physical and psychological function using mixed modeling procedures. Physical function significantly declined from pre-implant to one month post-implant (B = -10.05, = 0.004) and then nearly returned to the pre-implant level at six months post-implant (B = 8.34, = 0.028). This level of improvement continued through 12 months post-implant. In psychological distress, significant improvements were observed from pre-implant to one month (anxiety (B = -1.20, = 0.020) and in depressive symptoms (B = -1.15, = 0.037)), which then plateaued without significant changes from one to 12 months. We concluded that physical function recovery occurred six months post-implant, but function remained poor until 12 months post-implant. Psychological distress improved one month post-implant and it was maintained. Clinicians must provide more intensive interventions to improve long-term physical function after ICD therapy.
在西方国家,接受植入式心脏复律除颤器(ICD)治疗的患者常常会经历痛苦的身体和心理调适过程。社会文化因素可能会对植入后的恢复产生影响;然而,目前缺乏来自其他种族/文化背景的相关证据。本研究旨在调查接受ICD治疗的韩国患者从植入前到植入后1个月、6个月及12个月时身体功能和心理困扰(焦虑和抑郁症状)的变化情况。共有34名患者采用混合建模程序接受了从植入前到植入后的身体和心理功能纵向评估。身体功能在植入前到植入后1个月时显著下降(B = -10.05,P = 0.004),然后在植入后6个月时几乎恢复到植入前水平(B = 8.34,P = 0.028)。这种改善水平一直持续到植入后12个月。在心理困扰方面,从植入前到1个月时观察到显著改善(焦虑(B = -1.20,P = 0.020)和抑郁症状(B = -1.15,P = 0.037)),之后趋于平稳,从1个月到12个月没有显著变化。我们得出结论,身体功能在植入后6个月时开始恢复,但直到植入后12个月功能仍较差。心理困扰在植入后1个月时有所改善,并得以维持。临床医生必须提供更强化的干预措施,以改善ICD治疗后的长期身体功能。