Key result
Social cognitive intervention fails to mitigate worse physical symptoms in SCA survivors vs other arrhythmia patients.
Why the study?
Sudden cardiac arrest survivorship results in unique issues in return to physical and psychological function, motivating a comparison of recovery over the first year between sudden cardiac arrest survivors and other arrhythmia patients receiving an initial ICD.
Does a social cognitive theory intervention improve physical function, psychological adjustment, and self-efficacy in sudden cardiac arrest survivors compared to other arrhythmia patients receiving an initial ICD for secondary prevention?
RCT (n=168)
random number generator program
Yes
Does a social cognitive theory intervention improve physical function, psychological adjustment, and self-efficacy in sudden cardiac arrest survivors compared to other arrhythmia patients receiving an initial ICD for secondary prevention?
Sudden cardiac arrest survivors experience more physical symptoms and lower mental health and outcome expectations over 12 months compared to other arrhythmia patients, despite participating in a social cognitive theory intervention.
Answers are grounded in this paper and cite their sources.
SCA survivors warrant closer symptom monitoring post-ICD despite SCT; extends evidence on heterogeneous recovery in secondary-prevention ICD recipients.
Background Sudden cardiac arrest (SCA) survivorship results in unique issues in return to physical and psychological function. The purpose of the study was to compare recovery across the first year between SCA survivors and other arrhythmia patients who received an initial implantable cardioverter defibrillator (ICD) for secondary prevention, participating in a social cognitive theory (SCT) intervention.Methods 168 (129 males, 39 females) who received an ICD for secondary prevention (SCA N=65; other arrhythmia N=103) were randomized to one of two study conditions: SCT intervention (N=85) or usual care (N=83). Outcomes were measured at baseline hospital discharge, 1, 3, 6, & 12 months: 1) Physical Function: Patient Concerns Assessment (PCA), SF-36 (PCS); 2) Psychological Adjustment: State Trait Anxiety (STAI), CES-D depression, SF-36 (MCS); 3) Self-Efficacy: Self-Efficacy (SCA-SE), Self-management Behaviors (SMB), Outcome Expectations (OE). Outcomes were compared over 12 months for intervention condition x ICD indication using general estimating equations.Results Participants were Caucasian (89%),age 63.95+12.3 years, mean EF% 33.95+13.9, BMI 28.19+6.2, and Charlson Index 4.27+2.3. Physical symptoms (PCA) were higher over time for SCA survivors compared to the other arrhythmia group (p=0.04), ICD shocks were lower in SCA survivors in the SCT intervention (p=0.01); psychological adjustment (MCS) was significantly lower in SCA survivors in the SCT intervention over 6 months, that improved at 12 months (p=0.05); outcome expectations (OE) were significantly lower for SCA survivors in the SCT intervention (p=0.008).Conclusions SCA survivors had greater number of physical symptoms, lower levels of mental health and outcome expectations over 12 months despite participation in a SCT intervention.Trial registration: Clinicaltrials.gov: NCT04462887
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Dougherty et al. (2022) conducted an RCT in Sudden cardiac arrest or other complex cardiac arrhythmias requiring secondary prevention ICD (n=168). Social cognitive theory (SCT) intervention vs. Usual care was evaluated on Physical symptoms (Patient Concerns Assessment) over 12 months (p=0.04). SCA survivors had more physical symptoms (p=0.04) and lower outcome expectations (p=0.008) over 12 months compared to other arrhythmia patients, despite a social cognitive theory intervention.
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