Patients' and Families' Psychological Response to HAT

描述（由申请人提供）：“患者和家属对HAT的心理反应（PRHAT）”构成了一个独立的项目，补充了正在进行的NIH临床试验“家庭自动体外除颤器试验（HAT）”。PRHAT将调查心肌梗死后患者及其配偶/同伴在接受心脏骤停（SCA）应对训练后焦虑和抑郁的长期变化，以及社会支持和家庭应对技能对这些变化的调节作用。先前的研究表明，训练家庭成员进行心肺复苏术会增加心肌梗死后患者和训练家庭成员的焦虑和抑郁。心梗后患者的焦虑和抑郁与SCA相关。PRHAT是第一个研究心肌梗死（MI）患者及其配偶/伴侣对SCA训练的长期心理反应（焦虑和抑郁）的研究。它将比较标准外行培训（呼叫EMS/CPR）和标准外行培训加使用家庭自动体外除颤器（AED）的结果，并检查社会支持和家庭应对技能对患者及其配偶/同伴焦虑和抑郁的调节作用。在美国，每年至少发生20万例sca，其中70%发生在家中，并且有目击者。在头十分钟内，存活率每分钟下降10%，因此立即有效的应对措施至关重要。HAT的中心假设是，为家庭使用提供AED将比典型的对SCA的非卧床反应提高生存率。PRHAT将从参加该计划的7,000对患者-配偶/伴侣中招募440对。PRHAT将在研究开始时评估焦虑、抑郁、社会支持和家庭应对，并对患者及其配偶进行一个月、一年和两年的随访。PRHAT管理的工具将提供必要的信息，以补充和扩大HAT的影响，同时尽量减少参与者的负担。HAT将提供基础设施，包括选址、受试者招募和筛选、标准化CPR视频指导、AED设备、生活质量评估，以及促进心肌梗死后患者及其配偶/同伴的随访。HAT临床试验将于2002年10月1日开始招募参与者，并持续到2005年3月1日。PRHAT于2003年7月1日开始，有充足的时间同时招聘到HAT/PRHAT。PRHAT数据将确定易患焦虑和抑郁的患者和家庭。

DESCRIPTION (provided by applicant): "Patients' and Families' Psychological Response to HAT (PRHAT)" constitutes an independent project complementary to the ongoing NIH clinical trial "Home Automatic External Defibrillator Trial (HAT)". PRHAT will investigate long-term changes in anxiety and depression and the moderating influences of social support and family coping skills on these changes for post MI patients and their spouses/companions after training to respond to sudden cardiac arrest (SCA). Previous research has shown that training family members in CPR increases anxiety and depression in the post MI patient and the trained family member. Anxiety and depression in post-MI patients is associated with SCA. PRHAT is the first study to examine the long-term psychological responses (anxiety and depression) for post myocardial infarction (MI) patients and their spouse/companions to SCA training. It will compare the outcomes of standard lay training (call EMS/CPR) and standard lay training plus the use of a home automatic external defibrillator (AED) and examine the moderating effects of social support and family coping skills on anxiety and depression in both patients and the spouses/companions. At least 200,000 SCAs occur in the United States each year, 70% take place at home and are witnessed. Survival falls 10% per minute over the first ten minutes, therefore immediate, effective response is critical. The central hypothesis of HAT is that providing an AED for home use will improve survival beyond that achieved from the typical lay response to SCA. PRHAT will recruit 440 of the 7,000 patient-spouse/companion pairs enrolled in HAT. PRHAT will assess anxiety, depression, social support and family coping at study entry, and at one month, one year, and two-year follow ups for patients and spouses. The tools administered in PRHAT will provide essential information to complement and extend the impact of the HAT and while minimizing participant burden. The HAT will provide the infrastructure for sites, recruitment and screening of subjects, standardized CPR video instruction, the AED devices, quality of life assessment, and facilitation of follow up of post MI patients and their spouses/companions. HAT clinical trial will began recruiting participants on 10/01/02 and continue to 3/01/05. Beginning PRHAT on 7/01/03 allows ample time for simultaneous recruitment into HAT/PRHAT. PRHAT data will identify patients and families who are vulnerable to becoming anxious and depressed.