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삽입형 제세동기를 삽입한 대상자의 삶의 질과 영향 요인

Other Titles
 Factors associated with the quality of life of patients with implantable cardioverter defibrillators in South Korea 
Authors
 임지은 
College
 College of Nursing (간호대학) 
Department
 Dept. of Nursing (간호학과) 
Degree
석사
Issue Date
2019
Abstract
Background: While the number of patients with implantable cardioverter defibrillators (ICDs) has been increasing in South Korea, little is known about quality of life (QOL) or factors associated with QOL for ICD recipients in South Korea. Objectives: The purpose of this study was to describe the extent of ICD concerns, perceived control, social support, acceptance, and quality of life among ICD recipients and to determine predictors of QOL in this population. Methods: A descriptive survey design was applied with 109 ICD recipients who visited a university-affiliated hospital in Seoul, South Korea. For measurement, the Implanted Cardioverter Defibrillator Concerns Questionnaire (ICDC), Control Attitudes Scale—Revised (CAS-R), Multidimensional Scale of Perceived Social Support (MSPSS), Florida Patient Acceptance Survey (FPAS), and Korean version of the World Health Organization Quality of Life- Brief (WHOQOL-BREF) were used. Descriptive statistics were applied to describe the levels of the variables. Multiple regression was applied to determine predictors of QOL and its relationships with other factors. Results: The number of participants was 109, and the mean age was 52.66±14.34 years. The mean duration of ICD implant was 4.31±4.23 years, and the mean ejection fraction (EF) was 48.11%±16.18%. Additionally, 50.5% of the participants had their ICD inserted for secondary prevention, and 26.2% of them had experienced shock. Patients with ICD reported moderate level of ICD-related concerns (mean 15.02±9.25) and moderate to high levels of perceived control (mean 26.40±4.71), perceived social support (Mean 3.54±0.68), acceptance (mean 67.66±16.80), and QOL (mean 3.37±0.48). The recipients who had experienced shock (t=2.256, p=.026) or who had one or more comorbidities (t=2.798, p=.006) had higher ICD-related concerns. Compared to primary-prevention patients, secondary-prevention patients had more perceived control (t=−2.317, p=.022) and higher social support (t=−2.711, p=.008). Perceived control was significantly higher in patients who had an ICD for less than 2 years compared to those who had their ICD for more than 4 years (F=5.719, p=.004). The recipients who lived with their main caregiver had higher acceptance (t=2.713, p=.008) and QOL (t=2.351, p=.021) scores than those who lived alone. The NYHA class I patients had higher perceived social support (t=2.405, p=.018) and QOL (t=2.049, p=.043) than NYHA class II patients did. In addition, QOL was significantly lower in patients who had low income (p≤.001), had low education levels (p=.002), were unemployed (p=.012), and had one or more comorbidities (p=.010). The significant predicting factors associated with lower QOL were low perceived control, low acceptance of the device, low economic status, and one or more co-morbidities. These factors accounted for 43.3% of the variance in QOL. Conclusion: These findings suggest that appropriate screening is needed to detect vulnerable patients with ICD and that additional personalized interventions to improve QOL should be developed and provided to these populations.
Files in This Item:
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Appears in Collections:
3. College of Nursing (간호대학) > Others (기타) > 5. Others
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/178240
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