BACKGROUND:Implantable cardioverter defibrillator (ICD) patients potentially face significant psychological distress because of their risk for life-threatening arrhythmias and the occurrence of ICD shock. METHODS: The purpose of this study was to test an ICD stress and shock management program delivered in either a six-week format or a one-day workshop format. This intervention was aimed at reducing psychological (anxiety) and physiological (salivary cortisol) markers of distress in ICD patients. Secondary endpoints included measures of quality of life (QOL) and patient acceptance of device therapy, as well as biological mediators of inflammation (TNFalpha and IL-6). RESULTS: The ICD stress and shock management program resulted in the reduction of anxiety (P < 0.05) and cortisol levels (P < 0.05) in both the six weekly sessions format and the one-day workshop. Measures of anxiety decreased more rapidly with weekly intervention (P = 0.05). Both formats also resulted in a significant increase in patient acceptance of the ICD (P < 0.01). Follow-up assessment from posttreatment (T2) to four-month follow-up (T4) indicated no significant change in depression scores from posttreatment for all groups taken together, but there was a significant group by time effect, such that the workshop group displayed an increase in depression scores from T2 (M = 8.71, SD = 4.39) to T4 (M = 13.57, SD = 11.90), P < 0.05. CONCLUSIONS: These results suggest that structured interventions for shocked ICD patients involving ICD education and cognitive-behavioral strategies can reduce psychological distress and improve quality of life, regardless of format.
RCT Entities:
BACKGROUND: Implantable cardioverter defibrillator (ICD) patients potentially face significant psychological distress because of their risk for life-threatening arrhythmias and the occurrence of ICD shock. METHODS: The purpose of this study was to test an ICD stress and shock management program delivered in either a six-week format or a one-day workshop format. This intervention was aimed at reducing psychological (anxiety) and physiological (salivary cortisol) markers of distress in ICDpatients. Secondary endpoints included measures of quality of life (QOL) and patient acceptance of device therapy, as well as biological mediators of inflammation (TNFalpha and IL-6). RESULTS: The ICD stress and shock management program resulted in the reduction of anxiety (P < 0.05) and cortisol levels (P < 0.05) in both the six weekly sessions format and the one-day workshop. Measures of anxiety decreased more rapidly with weekly intervention (P = 0.05). Both formats also resulted in a significant increase in patient acceptance of the ICD (P < 0.01). Follow-up assessment from posttreatment (T2) to four-month follow-up (T4) indicated no significant change in depression scores from posttreatment for all groups taken together, but there was a significant group by time effect, such that the workshop group displayed an increase in depression scores from T2 (M = 8.71, SD = 4.39) to T4 (M = 13.57, SD = 11.90), P < 0.05. CONCLUSIONS: These results suggest that structured interventions for shocked ICDpatients involving ICD education and cognitive-behavioral strategies can reduce psychological distress and improve quality of life, regardless of format.
Authors: Gianfranco Buja; N A Mark Estes; Thomas Wichter; Domenico Corrado; Frank Marcus; Gaetano Thiene Journal: Prog Cardiovasc Dis Date: 2008 Jan-Feb Impact factor: 8.194
Authors: Jarrett Linder; Nadia Hidayatallah; Marina Stolerman; Thomas V McDonald; Robert Marion; Christine Walsh; Siobhan Dolan Journal: Einstein J Biol Med Date: 2013
Authors: Susanne S Pedersen; Viola Spek; Dominic A M J Theuns; Marco Alings; Pepijn van der Voort; Luc Jordaens; Pim Cuijpers; Johan Denollet; Krista C van den Broek Journal: Trials Date: 2009-12-23 Impact factor: 2.279