Dissertation/Thesis Abstract

Establishing a standard for peri-operative ICD education: A demonstration project
by Kirian, Kari B., Ph.D., East Carolina University, 2012, 83; 3526720
Abstract (Summary)

Introduction: An implantable cardioverter defibrillator (ICD) administers a shock to terminate potentially life-threatening cardiac arrhythmias. The device saves lives, but presents psychological challenges for patients. At present, there is a paucity of brief interventions for ICD patients designed for administration in a clinic setting that considers issues of cost, time, and available resources. The present study examined the impact of a brief cognitive behavioral (CBT) educational intervention on primary endpoints of patient acceptance and quality of life and secondary endpoints of depression and anxiety.

Methods: Sixty-two participants from clinics in NC and CO were recruited for the study 7-15 days post ICD implant. Thirty-three participants were randomized to the standard of care group (educational video + Q & A session) and 29 participants were randomized to the intervention group (educational video + Q & A session + take-home educational CBT booklet). Participants completed psychosocial measures prior to treatment and again at six weeks follow-up.

Results: Significant increases in pre-post patient acceptance across groups were evidenced t(44) = -2.13, p < .04 with a moderate effect (η2</super> = .09). There were no significant differences in quality of life. No significant differences were found on the secondary aim of depression. Contrary to our expectations, a significant difference was evidenced in anxiety between the control group (n = 19) and intervention group (n = 12) difference scores, U = 60.5, z = -2.20, p = .03, r = .40. Pre-post anxiety decreased significantly in the standard of care group, z = -2.69, p =.007, r = .34, but did not change significantly in the intervention group. Of note, nearly half the cases were excluded due to missing data.

Conclusions: A standardized peri-operative ICD education intervention increased patient acceptance. However, minimal treatment created minimal effects on anxiety, depression, and quality of life scores. A more intensive intervention may be needed to significantly impact psychological distress. Our data suggests that patients may be affectively primed by health information that could hinder a natural improvement in psychological adjustment. Dosage and desire for the provision of health information should be considered in future interventions with ICD patients.

Indexing (document details)
Advisor: Sears, Samuel F.
Commitee: Campbell, Lisa, Lutes, Lesley, McCammon, Susan, Wuensch, Karl L.
School: East Carolina University
Department: Psychology: Clinical Psychology
School Location: United States -- North Carolina
Source: DAI-A 74/01(E), Dissertation Abstracts International
Subjects: Clinical psychology, Health education
Keywords: Implantable cardioverter defibrillator, Patient education
Publication Number: 3526720
ISBN: 9781267606723
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