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June 1, 2000Pacing and Clinical Electrophysiology146 citationsOpen Access

Assessing the Psychosocial Impact of the ICD: A National Survey of Implantable Cardioverter Defibrillator Health Care Providers

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SSSamuel F. SearsJTJohn F. TodaroGUGuido G. Urizar

Key Result

ICD therapy was perceived by 15% of surveyed health care providers (n=261) to worsen patient quality-of-life postimplantation, with 10%-20% noting worse emotional functioning.

Study Design

Type

Cross-Sectional (n=261)

Multicenter

Yes

Structured PICO

P
Population
261 health care providers (e.g., physicians, nurses) caring for implantable cardioverter defibrillator (ICD) recipients
I
Intervention
Survey assessing perceptions of ICD recipients' quality-of-life, psychosocial functioning, concerns, and provider comfort in managing them
O
Outcome
Health care provider perceptions regarding quality-of-life, psychosocial functioning, concerns reported by ICD recipients, and degree of provider comfort in managing these concerns

Health care providers recognize that a significant minority of ICD recipients experience worsened quality-of-life and emotional functioning, yet providers feel least comfortable managing these psychosocial issues.

Abstract

The implantable cardioverter defibrillator (ICD) provides a survival advantage over antiarrhythmic medications for patients with life-threatening ventricular arrhythmias. However, the effect of ICD therapy on quality-of-life and psychosocial functioning are not as well understood. Health care providers (e.g., physicians, nurses) can serve as a valuable source of information related to these ICD outcomes. The purpose of this study was to investigate health care provider perceptions regarding: (1) the quality-of-life and psychosocial functioning of their ICD recipients, (2) the concerns or problems reported by ICD recipients, and (3) the degree of provider comfort in managing these concerns. The final sample of health care providers (n = 261) rated ICD recipients' global quality-of-life and psychosocial functioning, and specific concerns about health care, lifestyle, special population adjustment, marital and family adjustment, and emotional well-being. With regard to quality-of-life, health care providers reported that the majority of ICD recipients were functioning better (38%) or about the same (47%) than before implantation. However, health care providers reported that 15% of recipients experienced worse quality-of-life postimplantation. Similarly, health care providers indicated that 10%-20% of ICD recipients experienced worse emotional functioning and strained family relationships. Moreover, issues related to driving, dealing with ICD shocks, and depression were the most common ICD recipient concerns. Significant differences were noted between physicians and nurses/other health care professionals on a wide range of psychosocial issues. Health care providers generally reported the most comfort dealing with traditional medical issues (i.e., patient adherence), and the least comfort in managing emotional well-being issues (e.g., depression and anxiety). These results suggest that routine attention to ICD quality-of-life and psychosocial outcomes is indicated for health care providers who care for ICD recipients.

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Cite This Study

Sears et al. (2000) conducted a cross-sectional in Implantable Cardioverter Defibrillator (ICD) recipients (n=261). Implantable Cardioverter Defibrillator (ICD) was evaluated on Health care provider perceptions regarding quality-of-life, psychosocial functioning, and concerns of ICD recipients. ICD therapy was perceived by 15% of surveyed health care providers (n=261) to worsen patient quality-of-life postimplantation, with 10%-20% noting worse emotional functioning.

synapsesocial.com/papers/6a18b93a0048a5c8b24ace54https://doi.org/10.1111/j.1540-8159.2000.tb00878.x
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