PSYCHOSOCIAL FACTORS IN SUDDEN CARDIAC DEATH

心脏性猝死(SCD)是人类的主要公共卫生问题之一 西方社会面临的问题，它是导致 美国的死亡率。这项提案构成了一个独立的 美国国立卫生研究院正在进行的临床试验“心脏”的补充项目 心律失常抑制试验(CAST)“。CAST方案是 旨在检查抗心律失常药物的有效性 提高心肌梗塞后患者存活率的治疗方法 室性心律失常患者。这份提案是专门设计的 来考察社会心理学的贡献，以及 影响这些患者生存的行为因素。一批 社会和心理变量与发病率有关 或死于心血管疾病。无党派人士 这些心理和社会因素之间的贡献和相互关系 SCD死亡率的生理危险因素将被检查。它 假设生理状态将更强烈地与 与心理社会变量相比，更重要的是增加了 心理社会变量将显著增加 对生存时间的解释做出了贡献。 所有参加8个铸型点(n=800)的患者将被 被要求参与这项研究。演员入选标准为 旨在将参与限制在风险较高的人群中 SCD，但没有医学并发症，这将阻止或 使药物治疗复杂化。每一名受试者都将完成心理社会 在基线和随访期间每4个月进行一次问卷调查 探访了两年。 这项研究将为亚群的鉴定提供依据 心肌梗死后患者的心理社会状况 增加对SCD的易感性。护士扮演着主要的治疗角色 在这些患者的识别和管理中的作用 提供必要的干预措施以提高存活率。

Sudden cardiac death (SCD) is one of the major public health problems facing western society, and it is the leading cause of mortality in the U.S. This proposal constitutes an independent project complimentary to the ongoing NIH clinical trial "Cardiac Arrhythmia Suppression Trial (CAST)". The CAST protocol is designed to examine the effectiveness of antiarrhythmic drug therapy at improving survival among post-myocardial infarction patients with ventricular arrhythmias. This proposal is designed to examine the contributions of social psychological, and behavioral factors to survival in these patients. A number of social and psychological variables have been related to morbidity or mortality from cardiovascular diseases. The independent contributions and interrelationships among these psychosocial and physiological risk factors for SCD mortality will be examined. It is assumed that physiological status will be more strongly related to survival than psychosocial variables, but the addition of psychosocial variables will make significant additional contributions to the explanation of length of survival. All patients who are participating in 8 CAST sites (n=800) will be asked to participate in this study. CAST inclusion criteria are designed to limit participation to a population with high risk for SCD but without medical complications which would preclude or complicate drug therapy. Each subject will complete psychosocial questionnaires at baseline and every 4 months during follow-up visits for two years. This study will provide the basis for identification of a subgroup of post myocardial infarction patients whose psychosocial status promotes susceptibility to SCD. Nurses play a major therapeutic role in the identification and management of these patients and can provide the interventions necessary to improve survival.