Patients' and Families' Psychological Response to HAT

描述(由申请者提供)：“患者及其家属对HAT的心理反应(PRHAT)”是对正在进行的NIH临床试验“家庭自动体外除颤器试验(HAT)”的一个独立项目。PRHAT将调查心肌梗死后患者及其配偶/伴侣在接受心脏骤停(SCA)应对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缓和影响。先前的研究表明，对家庭成员进行CPR培训会增加MI后患者和接受过培训的家庭成员的焦虑和抑郁。心肌梗死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/伴侣对SCA训练的长期心理反应(焦虑和抑郁)的研究。它将比较标准的家庭训练(称为EMS/CPR)和标准的家庭训练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缓解作用。美国每年至少发生200,000起SCA事件，其中70%发生在家里，并得到了亲眼目睹。在最初的十分钟内，存活率每分钟下降10%，因此立即、有效的反应至关重要。HAT的中心假设是，提供家庭使用的AED将提高存活率，而不是典型的普通人对SCA的反应。PRHAT将招募HAT登记的7000对患者-配偶/伴侣中的440对。PRHAT将在研究开始时以及患者和配偶的一个月、一年和两年的随访中评估焦虑、抑郁、社会支持和家庭应对方式。PRHAT管理的工具将提供必要的信息，以补充和扩大HAT的影响，同时最大限度地减少参与者的负担。HAT将为选址、招募和筛选受试者、标准化的CPR视频指导、AED设备、生活质量评估以及促进心肌梗塞后患者及其配偶/伴侣的随访提供基础设施。HAT临床试验将于10/01/02开始招募参与者，并将持续到3/01/05。从2003年7月1日开始，PRHAT允许有充足的时间同时招募到HAT/PRHAT。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.