Relationship between Uncertainty and Health-related Quality of Life in Patients with Implantable Cardioverter-Defibrillators: Mediating Effect of Self-care Competence

Purpose: This descriptive survey examined the mediating effect of self-care competence on the relationship between uncertainty and health-related quality of life (HRQoL) in patients with implantable cardioverter-defibrillators (ICDs). Methods: Data were collected from 108 patients with ICDs who were receiving outpatient treatment at a tertiary hospital in J, Korea. Data were analyzed using SPSS/WIN 25.0 with descriptive statistics, the independent t-test, one-way analysis of variance, Pearson's correlation coefficient, and Hayes' PROCESS macro Model 4 with 95% bias-corrected bootstrap confidence intervals. Results: Uncertainty had a significant negative effect on physical HRQoL (β=-9.74, p=.014), whereas self-care competence had a significant positive effect on physical HRQoL (β =5.46, p=.004); the model explained 46% of the variance. The indirect effect of uncertainty on physical HRQoL through self-care competence was significant (indirect effect=-3.26, 95% bootstrap CI: -8.81 to -0.16). Uncertainty also had a significant negative effect on mental HRQoL (β=-15.17, p<.001), whereas self-care competence had a significant positive effect on mental HRQoL (β=5.80, p=.004); the model explained 39% of the variance. The indirect effect of uncertainty on mental HRQoL through self-care competence was significant (indirect effect=-4.52, 95% bootstrap CI: -10.08 to -0.14). Conclusion: Nursing interventions that strengthen self-care competence for continuous self-management are needed to reduce uncertainty and improve quality of life in patients with ICDs.