Key result
Negative treatment expectations on the EXPECT-ICD scale were associated with higher anxiety (β=0.443), depression (β=0.506), and ICD concerns (β=0.428) at 3 months post-implant (all P<0.001).
Why the study?
Does the EXPECT-ICD scale predict anxiety, depression, and ICD-related concerns 3 months post-implant in ICD patients?
Observational
Yes
Does the EXPECT-ICD scale predict anxiety, depression, and ICD-related concerns 3 months post-implant in ICD patients?
Effect estimate: β = 0.443 (anxiety), β = 0.506 (depression), β = 0.428 (ICD concerns)
p-value: p=< 0.001
The EXPECT-ICD scale is a valid tool for identifying ICD patients at risk for anxiety, depression, and ICD-related concerns based on their negative treatment expectations.
May flag ICD patients for psychological support; hypothesis-generating pending prospective trials.
AIMS: Patient treatment expectations may affect cardiac outcomes; however, till date, no validated instruments have been developed to monitor treatment expectations in patients with an implantable cardioverter-defibrillator (ICD). This study evaluates the predictive value of the newly developed 10-item EXPECtations Towards ICD therapy (EXPECT-ICD) in relation to anxiety, depression, and ICD related concerns 3 months post-implant. METHODS AND RESULTS: Consecutive implanted ICD patients were included as part of the WEB-based distress management programme for ICD patients (WEBCARE) trial from six Dutch referral hospitals. The patients completed the baseline questionnaires briefly after ICD implantation. Information on clinical variables was captured from the patients' medical records. Patients' treatment expectations as assessed with the EXPECT-ICD questionnaire could best be represented with a two-factor model involving both negative (α = 0.84) and positive expectations (α = 0.77) with a score range of 0-20 for each factor. Negative treatment expectations were associated with higher levels of anxiety (β = 0.443; P < 0.001), depression (β = 0.506; P < 0.001), and ICD concerns (β = 0.428; P < 0.001) 3 months post-implant after controlling for demographic and clinical factors. Positive expectations were not related to any of the distress outcomes. CONCLUSION: Negative expectations were associated with anxiety, depression, and ICD concerns 3 months post-implant. The current findings indicate that the EXPECT-ICD scale is a reliable, valid, and disease-specific measure of the treatment expectations in ICD patients. Future research needs to investigate whether addressing the patients' expectations might improve the outcome and the subjective well-being of ICD patients.
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Habibović et al. (2014) conducted an observational in Implantable cardioverter-defibrillator (ICD). Negative treatment expectations (EXPECT-ICD scale) was evaluated on Anxiety, depression, and ICD related concerns 3 months post-implant (β = 0.443 (anxiety), β = 0.506 (depression), β = 0.428 (ICD concerns), p=< 0.001). Negative treatment expectations on the EXPECT-ICD scale were associated with higher anxiety (β=0.443), depression (β=0.506), and ICD concerns (β=0.428) at 3 months post-implant (all P<0.001).
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