Effect of a Psychoeducational Intervention on Depression, Anxiety, and Health Resource Use in Implantable Cardioverter Defibrillator Patients

Dunbar, Sandra B.; Langberg, Jonathan J.; Reilly, Carolyn Miller; Viswanathan, Bindu; McCarty, Frances; Culler, Steven D.; O'Brien, Marian C.; Weintraub, William S.

doi:10.1111/j.1540-8159.2009.02495.x

Cited by 91 publications

(110 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Despite this, the mean functional capacity was high, with a DASI score of 48.1 (ceiling value, 58.2), corresponding to an estimated peak oxygen uptake of 30.3 mL/kg per minute, which was more favorable than those of other ICD populations (mean DASI score, 17-21). 13 This finding reflects the relative disconnect between arrhythmia risk and extent of structural and functional remodeling in ARVC.…”

Section: Article See P 18mentioning

confidence: 98%

“…Finally, exercise training as part of a comprehensive cardiac rehabilitation program has reduced anxiety and depression and improved quality of life in ICD patients. 16,17 However, these studies enrolled older adults (mean age, late 50s), and the largest one specifically excluded patients with genetic arrhythmias, 13 so it remains to be seen whether similar interventions will be equally feasible and successful at reducing anxiety and improving quality of life in ICD patients with ARVC and other inherited cardiac diseases.…”

Section: Article See P 18mentioning

confidence: 99%

“…The most successful strategies for reducing anxiety in ICD patients involve cognitivebehavioral therapy to teach techniques to improve coping skills and illness appraisal, such as developing a shock plan and strategies to reduce negative thoughts. [13][14][15] Other important components of psychological intervention include ICDspecific education, symptom and stress management training, and group therapy. Finally, exercise training as part of a comprehensive cardiac rehabilitation program has reduced anxiety and depression and improved quality of life in ICD patients.…”

Section: Article See P 18mentioning

confidence: 99%

See 2 more Smart Citations

Anxiety in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy and Implantable Cardioverter Defibrillators

Day

2012

Circ Cardiovasc Genet

View full text Add to dashboard Cite

Section: Article See P 18mentioning

confidence: 98%

Section: Article See P 18mentioning

confidence: 99%

Section: Article See P 18mentioning

confidence: 99%

See 1 more Smart Citation

Anxiety in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy and Implantable Cardioverter Defibrillators

Day

2012

Circ Cardiovasc Genet

View full text Add to dashboard Cite

“…ICD implantasyonu sonrası daha iyi psikolojik sonuçlar elde etmek için grup ve telefon müdahale-lerinin klinik kullanımını destekleyecek ileri çalışmaların yapılması önerilmektedir. Telefonla danışma ve takibin, akut ve ayakta bakım arasındaki uçurumu kapatabilecek, maliyet etkin ve klinik olarak uygulanabilir bir yaklaşım olduğu, bir merkeze uzak ve gruplara katılamayacak olan hastalar için sonuçları iyileştirmede yardımcı olabileceği belirtilmiştir (20).…”

Section: Telefonla İzlemunclassified

Use of Technology in Training Patients With Implantable Cardioverter Defibrillator

Yardımcı¹,

Mert²

2014

MUSBED

View full text Add to dashboard Cite

“…[75][76][77][78][79] Research has shown that 25% of ICD recipients experience depression or anxiety problems, 80 with the majority receiving no formal treatment for psychological problems. 81 Only 3 out of 44 patients in our study disclosed psychological problems attributable to device implantation, which is lower than previous research.…”

Section: Implications For the Development Of Decision-support Toolsmentioning

confidence: 99%

A qualitative study of decision-making about the implantation of cardioverter defibrillators and deactivation during end-of-life care

Standing

Exley

Flynn

et al. 2016

Health Serv Deliv Res

View full text Add to dashboard Cite

Background Implantable cardioverter defibrillators (ICDs) are recommended for patients at high risk of sudden cardiac death or for survivors of cardiac arrest. All ICDs combine a shock function with a pacing function to treat fast and slow heart rhythms, respectively. The pacing function may be very sophisticated and can provide so-called cardiac resynchronisation therapy for the treatment of heart failure using a pacemaker (cardiac resynchronisation therapy with pacemaker) or combined with an ICD [cardiac resynchronisation therapy with defibrillator (CRT-D)]. Decision-making about these devices involves considering the benefit (averting sudden cardiac death), possible risks (inappropriate shocks and psychological problems) and the potential need for deactivation towards the end of life. Objectives To explore patients’/relatives’ and clinicians’ views/experiences of decision-making about ICD and CRT-D implantation and deactivation, to establish how and when ICD risks, benefits and consequences are communicated to patients, to identify individual and organisational facilitators and barriers to discussions about implantation and deactivation and to determine information and decision-support needs for shared decision-making (SDM). Data sources Observations of clinical encounters, in-depth interviews and interactive group workshops with clinicians, patients and their relatives. Methods Observations of consultations with patients being considered for ICD or CRT-D implantation were undertaken to become familiar with the clinical environment and to optimise the sampling strategy. In-depth interviews were conducted with patients, relatives and clinicians to gain detailed insights into their views and experiences. Data collection and analysis occurred concurrently. Interactive workshops with clinicians and patients/relatives were used to validate our findings and to explore how these could be used to support better SDM. Results We conducted 38 observations of clinical encounters, 80 interviews (44 patients/relatives, seven bereaved relatives and 29 clinicians) and two workshops with 11 clinicians and 11 patients/relatives. Patients had variable knowledge about their conditions, the risk of sudden cardiac death and the clinical rationale for ICDs, which sometimes resulted in confusion about the potential benefits. Clinicians used various metaphors, verbal descriptors and numerical risk methods, including variable disclosure of the potential negative impact of ICDs on body image and the risk of psychological problems, to convey information to patients/relatives. Patients/relatives wanted more information about, and more involvement in, deactivation decisions, and expressed a preference that these decisions be addressed at the time of implantation. There was no consensus among clinicians about the initiation or timing of such discussions, or who should take responsibility for them. Introducing deactivation discussions prior to implantation was thus contentious; however, trigger points for deactivation discussions embedded within the pathway were suggested to ensure timely discussions. Limitations Only two patients who were prospectively considering deactivation and seven bereaved relatives were recruited. The study also lacks the perspectives of primary care clinicians. Conclusions There is discordance between patients and clinicians on information requirements, in particular the potential consequences of implantation on psychological well-being and quality of life in the short and long term (deactivation). There were no agreed points across the care pathway at which to discuss deactivation. Codesigned information tools that present balanced information on the benefits, risks and consequences, and SDM skills training for patients/relative and clinicians, would support better SDM about ICDs. Future work Multifaceted SDM interventions that focus on skills development for SDM combined with decision-support tools are warranted, and there is a potential central role for heart failure nurses and physiologists in supporting and preparing patients/relatives for such discussions. Funding The National Institute for Health Research Health Services and Delivery Research programme.

show abstract

Effect of a Psychoeducational Intervention on Depression, Anxiety, and Health Resource Use in Implantable Cardioverter Defibrillator Patients

Cited by 91 publications

References 60 publications

Anxiety in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy and Implantable Cardioverter Defibrillators

Anxiety in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy and Implantable Cardioverter Defibrillators

Use of Technology in Training Patients With Implantable Cardioverter Defibrillator

A qualitative study of decision-making about the implantation of cardioverter defibrillators and deactivation during end-of-life care

Contact Info

Product

Resources

About