Factors associated with outcomes 3 months after implantable cardioverter defibrillator insertion.
BACKGROUND
Adjustment to living with an implantable cardioverter defibrillator (ICD) is a dynamic process that varies among individuals. The purpose of this study was to describe patterns of recovery and to examine the relationships among demographic and clinical factors, illness appraisal and coping behaviors, and outcomes of physical and emotional function in the early recovery period of the first 3 months after initial ICD insertion.


METHODS
Data were collected in the acute care setting and again at 1 and 3 months after ICD insertion. Subjects were 213 patients (83% men), ages 24-85 (mean 59.6) years. Demographic and clinical variables representing personal and situational factors, illness appraisal, and coping variables were examined using hierarchical multiple-regression analyses to predict outcomes of mood disturbance and functional status.


RESULTS
The data revealed that symptoms, illness appraisal, and coping behaviors significantly explained additional variance in both functional status and mood disturbance above that accounted for by the less modifiable demographic and clinical variables.


CONCLUSIONS
Symptoms, illness appraisal, and coping behaviors were predictors of outcomes in ICD patients. These factors are modifiable aspects of the recovery process, and interventions aimed at symptom management, appraisal reframing, and coping training should be tested to improve mood and functional outcomes for ICD patients.
Dunbar
S B
SB
Emory University, Nell Hodgson Woodruff School of Nursing, Atlanta, GA 30322, USA.
Jenkins
L S
LS
Hawthorne
M
M
Kimble
L P
LP
Dudley
W N
WN
Slemmons
M
M
Purcell
J A
JA
D000223:Adaptation, Psychological; D000328:Adult; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D017147:Defibrillators, Implantable / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D019919:Prosthesis Implantation / Q000451:nursing*; D016896:Treatment Outcome