Learning Objective #1: analyze the relationship between uncertainty and psychosocial adjustment among implantable cardioverter recipients over time.

Learning Objective #2: discuss how the relation between uncertainty and psychosocial adjustment among implantable cardioverter defibrillator recipients has implications for future research and nursing practice.

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Purpose. The aims of this study were: 1) to examine if there is a long term relationship between uncertainty and psychosocial adjustment among ICD recipients; and 2) to determine if changes in uncertainty and/or adjustment occur over time. Method. A correlational, longitudinal survey design was used and instruments included the Mishel Uncertainty in Illness Scale, the Psychosocial Adjustment to Illness Scale – Self Report, and a demographic questionnaire. Ninety-three of 94 participants in a previous study of uncertainty and adjustment were included in this follow-up investigation. Results. The following results are discussed: 1) the relationship between uncertainty and adjustment long after initial ICD implant; 2) uncertainty and/or adjustment during the first two months after ICD implant as predictors of future uncertainty and adjustment levels; and 3) uncertainty and/or adjustment changes over time. Data were analyzed using descriptive and inferential statistics, including means, standard deviations, ranges, correlations, multiple regression, repeated measures analysis of variance, and multivariate canonical variate analysis. Significance. This study advances nursing knowledge of uncertainty and psychosocial adjustment levels of ICD recipients over time. Findings help guide researchers regarding future areas of inquiry. Implications for nursing practice are also discussed.