Poster Presentation
Wednesday, July 11, 2007
9:00 AM - 9:45 AM
Wednesday, July 11, 2007
2:45 PM - 3:30 PM
Psychological Impact of Implantable Cardioverter Defibrillators on its Recipients
Erlinda C. Wheeler, DNS, RN1, Thomas Hardie, EdD, RN, CS, NP1, Ingrid Pretzer-Aboff, MA, RN1, Angela DiSabatino, MS, RN2, and Jennifer Saylor, MSN, APRN, BC3. (1) School of Nursing, University of Delaware, Newark, DE, USA, (2) Cardiovascular Research Program, Christiana Care Health Services, Newark, DE, USA, (3) Heart and vascular Interventional Services, Christiana Care Health Services, Newark, DE, USA
| Learning Objective #1: Identify the psychological effects of implantable cardioverter defibrillator on recipients one month, 6 months and 12 months post implant. |
| Learning Objective #2: State the physiologic variable that significantly related to anxiety. |
Introduction
The use of implantable cardioverter defibrillators (ICD) has become increasingly more common to treat patients with life threatening ventricular arrhythmias. While the mortality benefits are clear, researchers see a need for studies focusing on the psychological and emotional impact of ICDs on the recipients. Anxiety and depression are reported to be common emotional responses in patients with ICD.
The purposes of this study were to determine the impact of ICD on the psychological well-being of recipients and to explore the relationship of mood changes and physiological conditions.
Method This study was a 12 month longitudinal prospective study that tracked depression and anxiety levels of ICD recipients after ICD implant, 4-6 weeks, 6 months, and 12 months post implant using Zung's Self-Rating Anxiety Scale and Patient Health Questionnaire (PHQ-9) for depression.
Results There were 33 subjects enrolled in this study. Demographic and physiologic variables did not significantly relate to anxiety and depression levels. Ejection fraction (EF) did significantly relate to anxiety (p=0.03) but had no effect on depression. Overall depression and anxiety levels dropped significantly over time. However, the levels of anxiety were initially lower in the low EF group but increased over time.
Conclusions and implications
Anxiety and depression are common to patients who received an ICD but the intensity of these symptoms appears to wane over time. Ejection fraction status below 35 seems to offer some initial protection from anxiety, however it diminishes with time. The findings suggest that interventions should be implemented early since the needs are greatest in the first few months after ICD implant. Ejection fraction status merits further investigation to better understand its role in the reduction of early anxiety to determine if EF is a surrogate for other pharmacologic or physiologic processes.