Learning Objective #1: Describe a research design to investigate relationships among knowledge, uncertainty, and quality of life in persons living with an implantable cardiac defibrillator

Learning Objective #2: Discuss two clinical practice implications that can be derived from the findings of the study described in objective #1

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An implantable cardioverter defibrillator (ICD) is used to treat life-threatening arrhythmias in patients at risk for sudden cardiac death. The device, while life saving, has the effect of causing disruption in recipients' lives. Despite the number of people who have received an ICD, little is known about their ICD knowledge and the impact of this knowledge on their uncertainty and quality of life (QOL). The specific aim of this study was to explore these relationships. Using a descriptive correlational design with purposive sampling, data were collected from 90 ICD recipients who were patients at a cardiac clinic in the northeast. Four instruments were used to measure the study variables: (a) demographic and medical heart history questionnaire; (b) Sossong ICD Knowledge Questionnaire; (c) Mishel Uncertainty in Illness Scale; and (d) Ferrans and Powers Quality of Life Index . Descriptive statistics, Pearson product moment correlations, regression analyses, and T-tests were conducted. There were no significant relationships between ICD knowledge, uncertainty, and QOL. A significant inverse relationship was found between uncertainty and QOL (r = -.421, p < . 01). Age was predictive of QOL as older (age more than 65 years) ICD recipients had a higher QOL than recipients younger than 65. Education, ejection fractions, number of shocks, and time since implant were not predictive of ICD knowledge, uncertainty, or QOL. Overall, participants in this study were found to be redefining life and sustaining QOL while experiencing high levels of uncertainty. Nurses need to focus on the meaning ICD recipients have for ICD knowledge, uncertainty, and QOL when planning nursing interventions.