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Internettherapie für ICD-Patienten

Internet therapy for ICD-patients

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Zusammenfassung

Die Bedeutung implantierbarer Kardioverter-Defibrillatoren (ICD) zur Prävention lebensbedrohlicher Herzrhythmusstörungen steigt aufgrund ihrer hervorragend belegten medizinischen Wirksamkeit stetig an. Dass ICD-Träger nach der Implantation oft psychosoziale Probleme wie Angst und Depression haben, wird in der medizinischen Routinenachsorge kaum thematisiert. Wegen der eingeschränkten Mobilität vieler ICD-Patienten liegt eine standortunabhängige Versorgung über das Internet nahe.

Unsere Pilotstudie und entsprechende Fallbeispiele zeigen Chancen und Herausforderungen solcher Angebote auf. Das von uns entwickelte Präventionsprogramm icd-forum.de umfasste medizinisch-psychologische Informationen, eine virtuelle Selbsthilfegruppe und einen moderierten Expertenchat mit dem Ziel, Ängste und verringerte Lebensqualität abzubauen. Im Kontext weiterer Studien erlaubt die kritische Bewertung des Programms die Ableitung von Gestaltungsempfehlungen für zukünftige Internetangebote zur psychosozialen Betreuung von ICD-Patienten. Nach unserer Meinung bieten solche Programme gerade für kardiologische Patienten Vorteile und sprechen für einen vermehrten Einsatz. Voraussetzung dafür sind aber aussagekräftige Evaluationen.

Abstract

Implantable cardioverter-defibrillators (ICD) are increasingly used for the prevention of potentially lethal cardiac arrhythmias due to their confirmed superior medical efficiency. Nevertheless, ICD-patients often suffer from psychosocial problems, e.g., anxiety and depression. These issues are rarely addressed in routine medical follow-up care. Due to the limited mobility of many ICD-patients, Internet-based care may be ideal for delivering psychosocial care to patients in their homes.

Our pilot study and case studies illustrate prospects and challenges of this approach. We developed icd-forum.de, a 6-week internet-based prevention program that provides a platform for information, a virtual self-help group, and a professionally moderated chat room in order to help decrease anxiety and to improve quality of life. A critical evaluation in the context of other published studies on the subject allows recommendations for the implementation of future internet-based psychosocial programs for ICD-patients to be deduced. It is the authors’ opinion that such programs offer advantages specifically for heart failure patients and they recommend their broader use. Prior to this, conclusive evaluation studies are needed.

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Literatur

  1. Albus C, Jordan J, Herrmann-Lingen C (2004) Screening for psychosocial risk factors in patients with coronary heart disease-recommendations for clinical practice. Eur J Cardiovasc Prev Rehabil 11:75–79

    Article  PubMed  Google Scholar 

  2. Andrews G, Cuijpers P, Craske MG et al (2010) Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: a meta-analysis. PloS one 5:e13196

    Article  PubMed  Google Scholar 

  3. Bostwick JM, Sola CL (2007) An updated review of implantable cardioverter/defibrillators, induced anxiety, and quality of life. Psychiatr Clin North Am 30:677–688

    Article  PubMed  Google Scholar 

  4. Connolly SJ, Hallstrom AP, Cappato R et al (2000) Meta-analysis of the implantable cardioverter defibrillator secondary prevention trials. Eur Heart J 21:2071–2078

    Article  PubMed  CAS  Google Scholar 

  5. Crössmann A (2005) Früherkennung und Prävention von Angststörungen bei Patienten mit implantierbarem Kardioverter-Defibrillator (ICD). urn:nbn:de:bvb:20-opus-16622

  6. Crössmann A, Pauli P, Dengler W et al (2007) Stability and cause of anxiety in patients with an implantable cardioverter-defibrillator: a longitudinal two year follow-up. Heart Lung 36:87–95

    Article  PubMed  Google Scholar 

  7. Crössmann A, Schulz SM, Kühlkamp V et al (2010) A randomized controlled trial of secondary prevention of anxiety and distress in a German sample of patients with an implantable cardioverter defibrillator. Psychosom Med 72:434–441

    Article  PubMed  Google Scholar 

  8. Dickerson SS (2005) Technology-patient interactions: Internet use for gaining a healthy context for living with an implantable cardioverter defibrillator. Heart Lung 34:157–168

    Article  PubMed  Google Scholar 

  9. Dickerson SS, Flaig DM, Kennedy MC (2000) Therapeutic connection: Help seeking on the Internet for persons with implantable cardioverter defibrillators. Heart Lung 29:248–255

    Article  PubMed  CAS  Google Scholar 

  10. Herrmann C, Buss U (1994) Vorstellung und Validierung einer deutschen Version der „Hospital Anxiety and Depression Scale“ (HAD-Skala). Ein Fragebogen zur Erfassung des psychischen Befindens bei Patienten mit körperlichen Beschwerden. Diagnostica 40:143–154

    Google Scholar 

  11. Hoyer J, Eifert GH, Einsle F et al (2008) Heart-focused anxiety before and after cardiac surgery. J Psychosom Res 64:291–297

    Article  PubMed  Google Scholar 

  12. Infratest (2010) (N) ONLINER Atlas 2010. Eine Topographie des digitalen Grabens durch Deutschland, Berlin/Bielefeld

  13. Kuhl EA, Sears SF, Conti JB (2006) Internet-based behavioral change and psychosocial care for patients with cardiovascular disease: a review of cardiac disease-specific applications. Heart Lung 35:374–382

    Article  PubMed  Google Scholar 

  14. Kuhl EA, Sears SF, Conti JB (2006) Using computers to improve the psychosocial care of implantable cardioverter defibrillator recipients. Pacing Clin Electrophysiol 29:1426–1433

    Article  PubMed  Google Scholar 

  15. Kuhl EA, Sears SF, Vazquez LD et al (2009) Patient-Assisted Computerized Education for Recipients of Implantable Cardioverter Defibrillators: A Randomized Controlled Trial of the PACER Program. J Cardiovasc Nurs 24:225–231

    PubMed  Google Scholar 

  16. Lemon J, Edelman S, Kirkness A (2004) Avoidance behaviors in patients with implantable cardioverter defibrillators. Heart Lung 33:176–182

    Article  PubMed  Google Scholar 

  17. May CD, Smith PR, Murdock CJ et al (1995) The impact of the implantable cardioverter defibrillator on quality-of-life. Pacing Clin Electrophysiol 18:1411–1418

    Article  PubMed  CAS  Google Scholar 

  18. Pauli P, Wiedemann G, Dengler W et al (2001) A priori expectancy bias and its relation to shock experience and anxiety: A naturalistic study in patients with an automatic implantable cardioverter defibrillator. J Behav Ther Exp Psychiatry 32:159–171

    Article  PubMed  CAS  Google Scholar 

  19. Pedersen SS, Spek V, Theuns DA et al (2009) Rationale and design of WEBCARE: a randomized, controlled, web-based behavioral intervention trial in cardioverter-defibrillator patients to reduce anxiety and device concerns and enhance quality of life. Trials 10:120

    Article  PubMed  Google Scholar 

  20. Pedersen SS, Van Den Broek KC, Sears SF Jr (2007) Psychological intervention following implantation of an implantable defibrillator: a review and future recommendations. Pacing Clin Electrophysiol 30:1546–1554

    Article  PubMed  Google Scholar 

  21. Rey GD (2009) E-Learning. Theorien, Gestaltungsempfehlungen und Forschung. Huber, Bern

  22. Sears SF, Lewis TS, Kuhl EA et al (2005) Predictors of quality of life in patients with implantable cardioverter defibrillators. Psychosomatics 46:451–457

    Article  PubMed  Google Scholar 

  23. Sears SF, Vazquez LD, Matchett M et al (2008) State-of-the-art: anxiety management in patients with implantable cardioverter defibrillators. Stress and Health 24:239–248

    Article  Google Scholar 

  24. Serber ER, Finch NJ, Afrin LB et al (2010) Using a webcast support service: Experiences of in-person attendees of an implantable cardioverter defibrillator support group. Heart Lung 39:94–104

    Article  PubMed  Google Scholar 

  25. Shetty AK, Behan MW, Bostock J et al (2010) Device therapy for the management of cardiac tachyarrhythmias. Expert Rev Cardiovasc Ther 8:1257–1266

    Article  PubMed  Google Scholar 

  26. Stephanie Bauer, Kordy H (2008) E-Mental-Health: Neue Medien in der psychosozialen Versorgung. Springer, Berlin

  27. Van Den Broek KC, Denollet J, Nyklicek I et al (2006) Psychological reaction to potential malfunctioning of implantable defibrillators. Pacing Clin Electrophysiol 29:953–956

    Article  Google Scholar 

  28. Van Den Broek KC, Habibovic M, Pedersen SS (2010) Emotional distress in partners of patients with an implantable cardioverter defibrillator: a systematic review and recommendations for future research. PACE 33:1442–1450

    Google Scholar 

  29. Vijgen J, Botto G, Camm J et al (2010) Consensus statement of the European Heart Rhythm Association: Updated recommendations for driving by patients with implantable cardioverter defibrillators. Eur J Cardiovasc Nurs 9:3–14

    Article  PubMed  Google Scholar 

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Interessenskonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht. Die Durchführung der Pilotstudie icd-forum.de wurde von der Firma St. Jude Medical finanziell unterstützt. Aktuell wird icd-forum.de durch das Bundesministerium für Bildung und Forschung gefördert.

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Authors and Affiliations

  1. Lehrstuhl für Psychologie I, Universität Würzburg, Marcusstr. 9–11, 97070, Würzburg, Deutschland

    S.M. Schulz &  P. Pauli

  2. Deutsches Zentrum für Herzinsuffizienz, Comprehensive Heart Failure Center (CHFC), Universitätsklinikum Würzburg, Würzburg, Deutschland

    S.M. Schulz &  P. Pauli

Authors
  1. S.M. Schulz
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  2. P. Pauli
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Correspondence to S.M. Schulz or P. Pauli.

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Schulz, S., Pauli, P. Internettherapie für ICD-Patienten. Herzschr. Elektrophys. 22, 166–173 (2011). https://doi.org/10.1007/s00399-011-0145-y

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