Gallagher R D, McKinley S, Mangan B, Pelletier D, Squire J, Mitten-Lewis S
Cooperative Research Centre for Cardiac Technology, University of Technology, Sydney, Australia.
Am J Crit Care. 1997 Jan;6(1):16-24.
The implantable cardioverter defibrillator may prolong survival and prevent sudden cardiac arrest in patients with ventricular arrhythmias. Whereas previous research focused on mortality, attention is now turning to the impact of the device on the recipient. We reviewed the literature on the effects of the implantable cardioverter defibrillator on recipients and their families; our aim was to consolidate our current understanding and guide further research in this area. We found a number of effects on which researchers agree. Primarily, recipients are happy to have the device and generally feel more confident. However, recipients experience many psychological reactions such as fear and anxiety that can be related to the unpredictable nature of the shocks. Recipients also are affected by intellectual changes. Both recipients and their families experience similar effects and use a range of coping mechanisms; the most effective is optimism. Only one nursing intervention has been investigated that directly addresses these effects. Areas that need more research are the effects of the implantable cardioverter defibrillator during childhood, adolescence, and pregnancy; the impact of vigilance on recipients and their families; costs; and nursing interventions. More consistent, standardized quality-of-life measures are needed so that comparisons can be made between samples.
植入式心脏复律除颤器可延长室性心律失常患者的生存期并预防心脏骤停。以往的研究聚焦于死亡率，而现在注意力正转向该设备对接受者的影响。我们回顾了关于植入式心脏复律除颤器对接受者及其家人影响的文献；我们的目的是巩固我们目前的认识并指导该领域的进一步研究。我们发现了一些研究者们一致认同的影响。首先，接受者乐于拥有该设备，总体上感觉更有信心。然而，接受者会经历许多心理反应，如恐惧和焦虑，这可能与电击的不可预测性有关。接受者也会受到智力变化的影响。接受者及其家人都经历类似的影响，并采用一系列应对机制；最有效的是乐观。仅一项直接针对这些影响的护理干预措施得到了研究。需要更多研究的领域包括植入式心脏复律除颤器在儿童期、青春期和孕期的影响；警惕性对接受者及其家人的影响；成本；以及护理干预措施。需要更一致、标准化的生活质量衡量标准，以便能够在样本之间进行比较。
