Patient and Partner Sexual Concerns During the First Year After an Implantable Cardioverter Defibrillator: A Secondary Analysis of the P+P Randomized Clinical Trial.
Patient and Partner Sexual Concerns During the First Year After an Implantable Cardioverter Defibrillator: A Secondary Analysis of the P+P Randomized Clinical Trial.
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植入式心脏复律除颤器后第一年患者和伴侣的性问题：PP 随机临床试验的二次分析。
DOI：
10.1016/j.jsxm.2020.01.028
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Dougherty,CynthiaM
中科院分区：
文献类型：
--
作者：
Streur,MeganM;Rosman,LindseyA;Sears,SamuelF;Steinke,ElaineE;Thompson,ElaineA;Dougherty,CynthiaM
背景性问题和性活动的变化在植入式心脏复律除颤器 (ICD) 后在患者及其亲密伴侣中很常见。目的我们的目的是 (i) 描述患者和伴侣的性活动和相关问题，从最初植入 ICD 到 12 个月的随访，以及 (ii) 确定预测恢复性活动的因素以及与性活动相关的恐惧。方法这项二次描述性分析是根据随机对照试验的数据进行的(2009-2015) 旨在比较植入初始 ICD 后针对患者（仅患者）和患者及其伴侣（患者+伴侣）的 2 种干预措施。样本包括 105 名患者及其亲密伴侣，他们报告了 ICD 植入前 24 个月内的性活动。结果性问题量表用于评估性活动和相关问题。结果研究参与者包括 72% 男性，平均年龄 65.6 ± 10.6 岁；伴侣中 64% 为女性，平均年龄为 63 ± 11.6 岁。 ICD 后性活动增加：73% 的患者表示在研究入组前 2 个月内没有性交，而只有 46% 的患者表示在 12 个月随访之前的 2 个月内没有性交。植入后 1 个月，对性的担忧明显减少，并持续减少了 12 个月（患者 6.48 ± 4.03 至 5.22 ± 3.38，P= .004；伴侣 6.93 ± 4.01 至 5.2 ± 3.56，P < .001）。患者的身体健康状况预测了种植体植入后 3 个月的性活动 (P=.04)；一般 ICD 担忧 (P< .001) 预测患者在 3 个月时会出现与 ICD 相关的性恐惧。 12 个月时，基线一般 ICD 担忧 (P< .02) 预测了性恐惧。临床意义 ICD 患者和伴侣报告在最初植入 ICD 时性活动水平较低，但在 12 个月的恢复期内性活动有所增加：ICD 植入后立即对性的担忧最高。 优点和局限性值得注意的是，本研究的主要优点是重复测量和纵向研究设计；该研究的主要局限性是缺乏“常规护理”对照组。 结论 初次植入 ICD 时的性活动较低，植入植入后立即对患者和伴侣而言，性问题最为突出。基线身体健康状况可预测 3 个月后的性活动，而与 ICD 相关的一般担忧可预测 3 个月和 12 个月时的性恐惧。
BackgroundSexual concerns and changes in sexual activity are common among patients and their intimate partners after an implantable cardioverter defibrillator (ICD).AimsOur aims were to (i) describe patient and partner sexual activity and related concerns from the time of an initial ICD implant through 12-month follow-up and (ii) identify factors predictive of return to sexual activity and fears associated with sexual activity.MethodsThis secondary descriptive analysis was conducted with data from a randomized controlled trial (2009–2015) designed to compare 2 interventions for patients (Patient-Only) and for patients and their partners (Patient+Partner) after implant of an initial ICD. The sample included 105 patients and their intimate partners who reported sexual activity during the 24 months before ICD implant.OutcomesThe Sexual Concerns Inventory was used to assess sexual activity and related concerns.ResultsStudy participants comprised 72% male and were of mean age 65.6 ± 10.6 years; partners comprised 64% female and were of mean age 63 ± 11.6 years. Sexual activity increased after ICD: 73% of patients reported no sexual intercourse during 2 months before study enrollment, whereas only 46% reported no sexual intercourse during the 2 months before 12-month follow-up. Reductions in sexual concerns were evident 1 month after implant, with continued reductions through 12 months (patient 6.48 ± 4.03 to 5.22 ± 3.38,P= .004; partner 6.93 ± 4.01 to 5.2 ± 3.56,P< .001). Patient physical health predicted sexual activity 3 months after implant placement (P= .04); general ICD concerns (P< .001) predicted patient ICD-related sexual fears at 3 months. At 12 months, baseline general ICD concerns (P< .02) predicted sexual fears.Clinical ImplicationsICD patients and partners report low levels of sexual activity at the time of initial ICD implant, with reported increases in sexual activity over the 12-month recovery period: Sexual concerns were highest immediately after ICD implant.Strengths & LimitationsNotably, the major strengths of this study were the repeated measures and longitudinal study design; the main limitation of the study was the lack of a “usual care” control group.ConclusionSexual activity at the time of an initial ICD implant is low, and sexual concerns are most prominent for both patients and partners immediately after implant placement. Baseline physical health predicts subsequent sexual activity at 3 months, while general ICD-related worry predicts sexual fears at 3 and 12 months.