Alcaraz Andreu Silvia, Hidalgo Montesinos María Dolores, Godoy Fernández Carmen, Fernández Ros Encarna, Sánchez Muñoz Juan José, García Alberola Arcadio
Escuela Internacional de Doctorado. Facultad de Psicología. Universidad de Murcia. Murcia. España.
Departamento de Psicología Básica y Metodología. Universidad de Murcia. España.
Rev Esp Salud Publica. 2020 May 27;94:e202005038.
The implantation of the Implantable Cardioverter Defibrillator (ICD) influences the psychological adjustment and the degree of subjective discomfort. The objective of this work was to analyze differences in psychological adjustment, fear of shocks and the degree of subjective discomfort derived from the illness depending on the reasons for implantation (primary vs secondary).
A sample of 82 patients with an ICD, for primary (58.5%) or secondary (41.5%) prevention indications was studied. A sociodemographic and clinical questionnaire and List of Brief Symptoms (LBS-50) was used. Descriptive univariate and bivariate analysis, t-tests on mean differences for independent samples and z-tests on proportion differences were performed.
Regarding psychological adjustment, 43.9% of the patients reported to have sleeping disorder, regardless the type of prevention. A greater percentage of patients of primary prevention had scored higher in clinical scales. The 29.4% of patients with secondary prevention reported to be afraid of experiencing some shock. The 25% of patients whose type of prevention was primary showed severe or moderate level of subjective discomfort derived from the illness compared with the 14.7% of the secondary prevention patients (p=0.7).
The patients with an ICD show symptoms clinically significant in Psychoactivity, Obsession-Compulsion, Anxiety, Somatization, Sleeping disorders and Psychopathology Risk Index. Both groups, regardless the type of prevention showed a similar psychological adjustment. Regarding the fear of shocks and the degree of subjective discomfort derived from the illness, no statistically significant differences between the groups were found.
植入式心脏复律除颤器（ICD）的植入会影响心理调适和主观不适程度。本研究的目的是分析因植入原因（一级预防与二级预防）不同而导致的心理调适、电击恐惧以及疾病引起的主观不适程度的差异。
对82例有ICD的患者进行研究，这些患者具有一级预防（58.5%）或二级预防（41.5%）指征。使用了社会人口统计学和临床问卷以及简明症状清单（LBS - 50）。进行了描述性单变量和双变量分析、独立样本均值差异的t检验以及比例差异的z检验。
关于心理调适，43.9%的患者报告有睡眠障碍，无论预防类型如何。一级预防患者在临床量表上得分较高的比例更大。29.4%的二级预防患者报告害怕经历电击。预防类型为一级的患者中有25%表现出由疾病引起的严重或中度主观不适，而二级预防患者的这一比例为14.7%（p = 0.7）。
植入ICD的患者在心理活动、强迫观念、焦虑、躯体化、睡眠障碍和精神病理学风险指数方面表现出具有临床意义的症状。两组患者，无论预防类型如何，心理调适情况相似。在电击恐惧和疾病引起的主观不适程度方面，两组之间未发现统计学上的显著差异。
