Price H, Obel I W, Millar R N
S Afr Med J. 1980 Apr 12;57(15):580-2.
The psychosocial effects of pacemaker implantation were analysed in 96 randomly selected patients receiving their first pacemaker at the Johannesburg General Hospital from August 1976 to December 1977. Premorbid personality together with emotional acceptance of the pacemaker was assessed by a social worker at interviews before implantation and 3 months and 1 year after implantation. Depression was measured by the Hamilton rating scale, and a psychosocial history was taken from each patient. The nature and severity of symptoms and associated diseases were assessed medically. Pacemaker implantation restores most patients to occupational, social, emotional and physical usefulness. The degree of relief of symptoms played an important part in rehabilitation. Inadequate adjustment and rehabilitation may occur in the presence of additional disease, unrealistic patient expectations, an inadequate, depressive personality type, poor doctor-patient communication, or in patients who have experienced symptoms for less than 1 month before the implantation. Adequate pre-operative preparation by a team of social workers and doctors together with public education and the provision of postoperative psychosocial support for the inadequate, depressive personality type and for patients suffering from additional disease is likely to enhance rehabilitation greatly.
1976年8月至1977年12月期间，在约翰内斯堡综合医院对96例首次接受起搏器植入的随机选择患者的起搏器植入的心理社会影响进行了分析。在植入前、植入后3个月和1年的访谈中，由一名社会工作者评估病前人格以及对起搏器的情感接受情况。采用汉密尔顿评定量表测量抑郁情况，并收集每位患者的心理社会病史。从医学角度评估症状的性质和严重程度以及相关疾病。起搏器植入使大多数患者恢复了职业、社交、情感和身体功能。症状缓解程度在康复中起重要作用。在存在其他疾病、患者期望不切实际、人格类型不适当且抑郁、医患沟通不足或植入前症状出现时间少于1个月的患者中，可能会出现调整和康复不足的情况。由一组社会工作者和医生进行充分的术前准备，同时开展公众教育，并为不适当、抑郁型人格以及患有其他疾病的患者提供术后心理社会支持，可能会大大提高康复效果。
