植入式心律转复除颤器患者的适应状况及相关因素

Adaptation status and related factors in patients living with implantable cardioverter defibrillators.

作者信息

Razavi Mohammadreza, Khatiban Mahnaz, Ahmadi Fazloallah, Oshvandi Khodayar

机构信息

Chronic Disease (Home Care) Center, Nursing and Midwifery School, Hamadan University of Medical Sciences, Hamadan, Iran.

Mother and Child Care Research Center, Nursing and Midwifery School, Hamadan University of Medical Sciences, Hamadan, Iran.

出版信息

J Family Med Prim Care. 2022 Aug;11(8):4467-4472. doi: 10.4103/jfmpc.jfmpc_2460_21. Epub 2022 Aug 30.

Abstract

INTRODUCTION

An implantable cardioverter-defibrillator (ICD) is the only approach to treat patients with life-threatening ventricular arrhythmias. Adaptation and acceptance of ICD play an important role in the optimal treatment of the patients. The aim of this study was to determine adaptation status and related factors in patients living with ICDs.

METHODS AND MATERIALS

In this descriptive-analytical study, 148 patients referred to Kowsar Hospital in Shiraz and Farshchian Hospital in Hamedan city between July 2020 and September 2021 were included in the study. Patients' adjustment status was measured based on the mode of the Roy nursing model and using the Baecke physical activity questionnaire, Pittsburgh sleep quality, mini nutritional assessment (MNA) nutrition questionnaire, constipation scoring questionnaire, self-concept scale, and multidimensional scale of perceived social support (MSPSS).

RESULTS

Patients had low physical activity and poor sleep quality. Negative self-concept in relation to the disease and adherence to physicians' recommendations was observed among patients. In addition, patients did not have optimal interpersonal communication. Multivariate regression findings showed that the number of years of device implantation and the number of shock discharges are effective factors in the incidence of insomnia and the negative self-concept of patients.

CONCLUSION

Patients living with ICD did not adjust to the new conditions after placement of the device. Low level of physical activity and sleep disturbance and also negative self-concept about the disease and adherence to treatment was observed among the patients. Shock discharges and duration of the device implantation were associated with impaired self-concept and insomnia in the patients.

摘要

引言

植入式心脏复律除颤器(ICD)是治疗危及生命的室性心律失常患者的唯一方法。ICD的适应和接受在患者的最佳治疗中起着重要作用。本研究的目的是确定ICD植入患者的适应状况及相关因素。

方法与材料

在这项描述性分析研究中,纳入了2020年7月至2021年9月期间转诊至设拉子的科萨尔医院和哈马丹市的法尔什奇安医院的148例患者。根据罗伊护理模式,使用贝克体育活动问卷、匹兹堡睡眠质量指数、微型营养评定(MNA)营养问卷、便秘评分问卷、自我概念量表和领悟社会支持多维量表(MSPSS)来测量患者的适应状况。

结果

患者体育活动水平低,睡眠质量差。患者中观察到与疾病相关的消极自我概念以及对医生建议的依从性。此外,患者没有良好的人际沟通。多变量回归结果表明,设备植入年限和电击次数是患者失眠发生率和消极自我概念的影响因素。

结论

ICD植入患者在设备植入后未适应新状况。患者中观察到体育活动水平低、睡眠障碍以及对疾病的消极自我概念和治疗依从性差。电击次数和设备植入时长与患者的自我概念受损和失眠有关。

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