title: Do positive health expectations and optimism relate to quality-of-life outcomes for the patient with an implantable cardioverter defibrillator?
abstract: OBJECTIVE
  Clinical trials with the implantable cardioverter defibrillator (ICD) have demonstrated desirable outcomes in terms of mortality and morbidity among patients with potentially lethal arrhythmias. This study examined the "resilience factors" of positive health expectations and global optimism prospectively using the general quality-of-life (QOL) scores of newly implanted ICD patients.
  
  
  METHODS
  The study enrolled 88 newly implanted ICD patients (mean age, 65.3 +/- 13.2 years; 83% male; 92% white) assessed 8 and 14 months after ICD implantation. A series of 2 x 2 factorial multivariate analyses of covariance were performed to examine the differences between baseline low versus high positive health expectations and baseline low versus high optimism in short- and long-term general QOL scores.
  
  
  RESULTS
  After control was used for ejection fraction (mean, 31%), the patients with baseline high positive health expectations reported better general health at a long-term follow-up assessment (P = .002). The patients with high optimism reported better mental health and social functioning at a short-term follow-up assessment (P =. 056), and this finding approached significance at a long-term follow-up assessment (P = .061).
  
  
  CONCLUSIONS
  Positive health expectations and optimism are differentially related to various components of QOL. Collectively, these two resilience factors may be targeted in future studies of interventions to improve QOL for ICD patients.
authors.affiliation: Department of Clinical Health Psychology, University of Florida, Gainesville, Florida, USA. ssears@phhp.ufl.edu
authors.forename: Samuel F
authors.initials: SF
authors.lastname: Sears
authors.forename: Eva R
authors.initials: ER
authors.lastname: Serber
authors.forename: Tara Saia
authors.initials: TS
authors.lastname: Lewis
authors.forename: Robyn L
authors.initials: RL
authors.lastname: Walker
authors.forename: Nancy
authors.initials: N
authors.lastname: Conners
authors.forename: John T
authors.initials: JT
authors.lastname: Lee
authors.forename: Anne B
authors.initials: AB
authors.lastname: Curtis
authors.forename: Jamie B
authors.initials: JB
authors.lastname: Conti
mesh_terms: D000368:Aged; D001294:Attitude to Health; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000503:physiopathology / Q000523:psychology; D017147:Defibrillators, Implantable / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D020377:Self Efficacy; D018434:Sickness Impact Profile; D013318:Stroke Volume / Q000502:physiology; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*