Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Department of Psychology, East Carolina University, Greenville, North Carolina, USA.
Heart Lung. 2021 Jan-Feb;50(1):153-158. doi: 10.1016/j.hrtlng.2020.05.003. Epub 2020 Jun 16.
Patient reported outcomes in Implantable Cardioverter Defibrillator (ICD) patients can describe the experience of living with heart disease and with an ICD. However, very little is known about patient outcomes among Chinese patients which may limit effective patient discussions and interventions for these patients. The purposes of this study were to examine device related experiences (e.g., device acceptance, shock anxiety) in Chinese ICD patients and identify potential variables that influence health related quality of life (HRQOL) and to compare HRQOL outcomes to healthy and heart failure populations.
This study used a cross-sectional research design with serially recruited ICD patients (N = 100) from clinics in China. Participants completed surveys including: the 12-Item Short-Form Health Survey Questionnaire (SF-12), Florida Patient Acceptance Survey (FPAS), Florida Shock Anxiety Scale (FSAS), Type D Scale (DS-14), and general information questionnaire.
Participants were 100 ICD patients in China with a mean age of 53.32(SD = 13.70). The mean scores of the SF-12 physical component summary (PCS) and mental component summary (MCS)of ICD patients (43.55 and 47.07, respectively) were lower than the Chinese general population (P<0.001) and general health, social functioning, and role emotional scores were lower than chronic heart failure patients (P<0.001). Multiple linear regression analysis indicated that LVEF, positive shock history, age and shock anxiety were significant predictors of physical function and accounted for 24.5% of the adjusted variance. Type D personality, shock history, and shock anxiety were predictors of the mental health component and accounted for 25.9% of the variance. Shock history, age, type D personality, and shock anxiety significantly predicted device acceptance (FPAS-Total) and accounted for 32% of variance.
ICD patients reported health outcomes were generally lower than the Chinese general population and patients with heart failure in relation to general health, social functioning, and role emotional. Both generic and disease specific HRQOL were influenced by both medical and psychosocial predictors. This suggests that current Western society based comprehensive models of patient HRQOL and patient care needs may extend to Chinese patients with ICDs.
植入式心脏复律除颤器（ICD）患者的患者报告结局可描述其患有心脏病和 ICD 的体验。然而，我们对中国患者的患者结局知之甚少，这可能会限制对这些患者进行有效的患者讨论和干预。本研究的目的是研究中国 ICD 患者的设备相关体验（例如，设备接受度、电击焦虑），并确定影响健康相关生活质量（HRQOL）的潜在变量，并将 HRQOL 结果与健康人群和心力衰竭人群进行比较。
本研究采用横断面研究设计，连续招募来自中国诊所的 100 名 ICD 患者。参与者完成了以下调查：12 项简短健康调查量表（SF-12）、佛罗里达州患者接受度调查（FPAS）、佛罗里达州电击焦虑量表（FSAS）、Type D 量表（DS-14）和一般信息问卷。
参与者为中国 100 名 ICD 患者，平均年龄为 53.32（SD=13.70）。ICD 患者的 SF-12 生理成分综合评分（PCS）和心理成分综合评分（MCS）的平均得分（分别为 43.55 和 47.07）均低于中国一般人群（P<0.001），且一般健康、社会功能和角色情绪评分均低于慢性心力衰竭患者（P<0.001）。多元线性回归分析表明，LVEF、阳性电击史、年龄和电击焦虑是生理功能的显著预测因素，占调整后方差的 24.5%。Type D 人格、电击史和电击焦虑是心理健康成分的预测因素，占方差的 25.9%。电击史、年龄、Type D 人格和电击焦虑显著预测设备接受度（FPAS-总分），占方差的 32%。
与一般健康、社会功能和角色情绪相比，ICD 患者报告的健康结局普遍低于中国一般人群和心力衰竭患者。一般和疾病特异性 HRQOL 受到医疗和社会心理预测因素的影响。这表明，目前基于西方社会的患者 HRQOL 和患者护理综合模型可能适用于中国 ICD 患者。
