Dougherty C M
University of Washington, School of Nursing, Seattle 98195, USA.
Heart Lung. 1995 Jul-Aug;24(4):281-91. doi: 10.1016/s0147-9563(05)80071-8.
The purpose of this study was to compare psychological reactions and family adjustment after sudden cardiac arrest (SCA) and internal cardioverter defibrillator (ICD) implantation in survivors who did and did not experience defibrillatory shocks the first year of recovery.
Data were collected as part of a longitudinal prospective study that examined patient and family adjustment after SCA. SCA survivors and one family member per patient were interviewed and completed questionnaires three times within the first year (hospital discharge, 6 months, and 12 months) after SCA.
Fifteen SCA survivors (13 men and 2 women) between the ages of 30 and 74 (mean 57 years) and one respective family member, usually the spouse, (mean age 53 years) participated. All SCA survivors had had primary ventricular fibrillation outside the hospital, had automatic defibrillators implanted while hospitalized, and were monitored for 1 year.
Participants were divided into shock and no shock groups based on activation of their ICD the first year. The mean number of shocks received in the shock group survivors was 26, with a range of 3 to 100. Anxiety, depression, anger, and stress levels were higher for both survivors and their family members in the group that received defibrillator shocks. Denial was high throughout the entire year in all survivors. Dyadic adjustment and family coping were not found to be significantly different between the no shock and shock groups. A trend toward reduction in family social support and dyadic satisfaction was noted in both groups with time.
Both SCA survivors and their family members experience more psychological distress in the first year after ICD implantation if the defibrillator fires. Families in both shock and no shock groups report lower levels of family support and marital satisfaction the first year after SCA and ICD implantation.
本研究旨在比较心脏骤停幸存者在复苏的第一年中，经历或未经历除颤电击后植入体内心脏复律除颤器（ICD）时的心理反应和家庭适应情况。
作为一项纵向前瞻性研究的一部分收集数据，该研究考察了心脏骤停后的患者和家庭适应情况。心脏骤停幸存者及其每位患者的一名家庭成员在心脏骤停后的第一年（出院时、6个月和12个月）接受了三次访谈并完成问卷调查。
15名年龄在30至74岁（平均57岁）之间的心脏骤停幸存者（13名男性和2名女性）及其各自的一名家庭成员（通常是配偶，平均年龄53岁）参与了研究。所有心脏骤停幸存者均在院外发生过原发性心室颤动，住院期间植入了自动除颤器，并接受了1年的监测。
根据第一年ICD的激活情况，参与者被分为电击组和无电击组。电击组幸存者接受电击的平均次数为26次，范围为3至100次。接受除颤电击的幸存者及其家庭成员的焦虑、抑郁、愤怒和压力水平更高。所有幸存者在一整年中否认情绪都很高。无电击组和电击组之间的二元调整和家庭应对方式没有显著差异。随着时间的推移，两组中家庭社会支持和二元满意度均有下降趋势。
如果除颤器放电，心脏骤停幸存者及其家庭成员在植入ICD后的第一年都会经历更多的心理困扰。电击组和无电击组的家庭在心脏骤停和植入ICD后的第一年报告的家庭支持和婚姻满意度水平较低。
