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Concerns about implantable cardioverter-defibrillator shocks mediate the relationship between actual shocks and psychological distress.
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.ORCID iD: 0000-0002-7097-392X
University of Kentucky, USA; University of Ulster, UK.
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.ORCID iD: 0000-0002-4259-3671
University of Kentucky, USA.
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2016 (English)In: Europace, ISSN 1099-5129, E-ISSN 1532-2092, Vol. 18, no 6, 828-835 p.Article in journal (Refereed) Published
Abstract [en]

AIMS: Although most implantable cardioverter-defibrillator (ICD) patients cope well, fears about receiving ICD shocks have been identified as a major determinant of psychological distress. The relationships among ICD-related concerns, receipt of defibrillating shocks, and symptoms of anxiety and depression have not yet been investigated. Our objective was to examine whether the relationship between receipt of defibrillating shocks and psychological distress was mediated by patients' concerns related to their ICD.

METHODS AND RESULTS: All Swedish ICD-recipients were invited to this cross-sectional correlational study; 3067 completing the survey (55% response rate). Their mean age was 66 ± 11 years, and 80% were male. One-third (35%) had received defibrillating shocks, and 26% had high ICD-related concerns. Regression analyses demonstrated that having received at least one shock significantly predicted symptoms of anxiety and depression [odds ratio (OR) 1.58 and OR 3.04, respectively]. The association between receipt of shocks and psychologically distress was mediated by high ICD-related concerns which explained 68% of the relationship between shocks and symptoms of anxiety, and 54% of the relationship between shocks and symptoms of depression.

CONCLUSION: Implantable cardioverter-defibrillator-related concerns have a bigger impact on psychological distress than receipt of an actual shock. Assessing ICD-related concerns in clinical practice can identify patients at risk for psychological distress. Further research on assessment of, and interventions targeting, ICD-related concerns is warranted.

Place, publisher, year, edition, pages
Oxford University Press, 2016. Vol. 18, no 6, 828-835 p.
Keyword [en]
Implantable cardioverter-defibrillator; ICD-related concerns; ICD shocks; Mediators; Psychological distress
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:liu:diva-124321DOI: 10.1093/europace/euv220ISI: 000379742500009PubMedID: 26324839OAI: oai:DiVA.org:liu-124321DiVA: diva2:897809
Note

Funding agencies: Medical Research Council of Southeast Sweden (FORSS); Swedish Heart and Lung Association

Available from: 2016-01-26 Created: 2016-01-26 Last updated: 2016-08-20Bibliographically approved

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Thylén, IngelaStrömberg, Anna
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Division of Nursing ScienceFaculty of Health SciencesDepartment of Cardiology in Linköping
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