Patients' and Families' Psychological Response to HAT

描述（由申请人提供）：“患者和家庭对HAT的心理反应（PRHAT）”是一个独立的项目，是对正在进行的NIH临床试验“家庭自动体外除颤器试验（HAT）”的补充。PRHAT将研究MI后患者及其配偶/同伴在接受应对心脏骤停（SCA）培训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。以前的研究表明，培训家庭成员在心肺复苏术增加焦虑和抑郁症后心肌梗死患者和训练有素的家庭成员。MI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）后患者及其配偶/同伴对SCA训练的长期心理反应（焦虑和抑郁）的研究。它将比较标准的非专业培训（称为EMS/CPR）和标准的非专业培训加上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/伴侣的焦虑和抑郁的调节作用。在美国，每年至少有20万起SCA发生，其中70%发生在家中，并有目击者。在最初的十分钟内，存活率每分钟下降福尔斯10%，因此立即有效的反应至关重要。HAT的核心假设是，提供家用AED将提高生存率，超出对SCA的典型非专业反应所达到的水平。PRHAT将从HAT招募的7,000对患者-配偶/伴侣中招募440对。PRHAT将在研究入组时以及患者和配偶的一个月、一年和两年随访时评估焦虑、抑郁、社会支持和家庭应对。在生殖健康风险评估测试中使用的工具将提供必要的信息，以补充和扩大生殖健康风险评估测试的影响，同时尽量减少参与者的负担。HAT将为研究中心提供基础设施、招募和筛选受试者、标准化CPR视频指导、AED设备、生活质量评估以及促进MI后患者及其配偶/伴侣的随访。HAT临床试验将于2002年10月1日开始招募受试者，并持续至2005年3月1日。2003年1月7日开始的PRHAT为HAT/PRHAT同时招募提供了充足的时间。PRHAT数据将识别容易变得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.