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The Effects of Psycho-Educational Intervention on Quality of Life in Patients with Implantable Cardioverter Defibrillators: A Meta-Analysis

Monday, 9 November 2015

Miao-Yi Chen, BS, RN1
Pai-Hui Lin, BS, RN1
Chi-Wen Kao, PhD, RN2
(1)School of nursing, National Defense Medical Center, Taipei, Taiwan
(2)School of Nursing, National Defense Medical Center, Taiwan, Taipei, Taiwan

Background: Sudden cardiac death (SCD) is an important clinical and public health problem. The implantable cardioverter defibrillator (ICD) is developed for primary and secondary prevention of SCD. Once the device is implanted, it becomes important for patients to regain life quality for integrating the devices into their lives. Quality of life has been identified as a significant predictor of mortality in ICD recipients.

Purpose: The aim of this meta-analysis was to evaluate the effects of psychological and educational interventions on quality of life in patients with ICDs.

Methods: We systematically searched the following databases: PubMed, Medline, Cochrane Library, and CINAHL up to November 2014 and references of relevant restricted articles. Studies were recruited in analysis if they met following criteria: (1) randomized controlled trial design, (2) participants in study were adult patients with ICD implanted, and (3) providing sufficient data to evaluate the effect of psychological or educational intervention on quality of life which was measured by SF-36 or SF-12. Two reviewers selected studies and extracted data independently. We used modified Jadad scale to evaluate the quality of these studies. The Cochrane Collaboration’s Review Manager Software Package (RevMan 5) was used for this meta-analysis. We pooled data across trials using the fixed-effects model. Heterogeneity was assessed by x2 test and I2 statistic.

Results: Seven randomized controlled trials fulfilled the inclusion criteria. A total of 1048 participants were recruited in these studies. The psychological and educational interventions improved more physical component summary (PCS) scores in the intervention groups (mean difference 1.97, 95% CI 0.76 to 3.19; test for overall effect Z= 3.19, p= 0.001), and mental component summary (MCS) scores (mean difference 1.23, 95% CI 0.02 to 2.44; test for overall effect Z= 2.00, p= 0.05) as well, compared with the control groups.

Conclusion: The meta-analysis demonstrates that psychological and educational interventions improve overall quality of life in patient with ICDs.

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