植入式心律转复除颤器手术前后患者确定感、焦虑与性格乐观状态的研究

The study of patient's moods of uncertainty, anxiety or optimism before and after ICD implantation

目的研究比较植入式心律转复除颤器(ICD)作为心源性猝死的一级预防(primary prevention,PP)和二级预防(secondary prevention,SP),在植入前、植入后1周以及植入后1个月对患者情绪的不同影响。方法选择15例患者应用植入式心律转复除颤器作为心源性猝死的PP,15例患者应用植入式心律转复除颤器作为心源性猝死的SP,应用描述性横断面调查法,利用Mishel-疾病不确定感量表(Mishel’s Uncertainty in Illness Scale,MUIS-C),特质状态焦虑量表(State-Trait Anxiety Inventory,STAI)和生活目标量表(the Life Orientation Test,LOT-R),通过晤谈行半结构访问。结果在植入式心律转复除颤器植入前,两组患者的MUIS-C分值都较高(PP=67.67±13.36;SP=70.27±6.80,P=0.507);LOT-R分值为PP=15.67±3.8,SP=16.47±3.6,P=0.557;STAI分值为PP=37.40±10.0,SP=37.73±13.6,P=0.940。在植入式心律转复除颤器植入后1个月,PP患者的MUIS-C分值明显低于SP患者(PP=62.33±4.17,SP=67.87±4.61,P=0.002)。结论利用植入式心律转复除颤器作为SP的患者护理时更应该引起护士的重视。

Objective To explore the influence of implantable cardioverter defibrillator（ICD）implantation, used as primary prevention（PP） or secondary prevention（SP） measure for cardiogenic sudden death, on patient＇s moods such as uncertainty, anxiety or optimism, and to compare the results between PP and SP. Methods ICD implantation, used as primary prevention measure, was performed in 15 patients（PP group）, and ICD implantation, used as secondary prevention measure, was carried out in other 15 patients（SP group）. Mishel＇s Uncertainty in Illness Scale（MUIS-C）, State-Trait Anxiety Inventory（STAI）, and the Life Orientation Test（LOT-R） were used as quantitative methods to evaluate patient＇s moods including anxiety, uncertainty or optimism in perioperative period. Results Before ICD implantation both PP group and SP group had high scores in MUIS-C（PP = 67.67 ± 13.36, SP = 70.27 ± 6.80, P = 0.507）, in LOT-R（PP = 15.67 ± 3.8, SP = 16.47 ± 3.6, P = 0.557）, and in STAI（PP = 37.40 ± 10.0, SP = 37.73± 13.6, P =0.940）. One month after ICD implantation MUIS-C score of PP group was significantly lower than that of SP group（PP = 62.33 ± 4.17, SP = 67.87 ± 4.61, P = 0.002）. Conclusion More nursing attention should be paid to the patients who receive ICD implantation as secondary prevention measure.