Age-specific differences in women with implantable cardioverter defibrillators: an international multi center study.
BACKGROUND
Common psychological adjustment difficulties have been identified for groups of implantable cardioverter defibrillator patients, such as those who are young (<50 years old), have been shocked, and are female. Specific aspects and concerns, such as fears of death or shock and body image concerns, that increase the chance of distress, have not been examined in different aged female implantable cardioverter defibrillator (ICD) recipients. The aim of the study was to investigate these areas of adjustment across three age groups of women from multiple centers.


METHODS
Eighty-eight female ICD patients were recruited at three medical centers: Shands Hospital at the University of Florida, Brigham and Women's Hospital in Boston, and Royal North Shore Hospital in Sydney, Australia. Women completed individual psychological assessment batteries, measuring the constructs of shock anxiety, death anxiety, and body image concerns. Medical record review was conducted for all patients regarding cardiac illnesses and ICD-specific data.


RESULTS
Multivariate and univariate analyses of variance revealed that younger women reported significantly higher rates of shock and death anxiety (Pillai's F=3.053, P=0.018, eta2p=0.067) and significantly greater body image concerns (Pillai's F=4.198, P=0.018, eta2p=0.090) than middle- and older-aged women.


CONCLUSIONS
Women under the age of 50 appear to be at greater risk for the development of psychosocial distress associated with shock anxiety, death anxiety, and body image. Clinical-based strategies and interventions targeting these types of adjustment difficulties in younger women may allow for improved psychosocial and quality of life outcomes.
Vazquez
Lauren D
LD
Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida 32610, USA. ldvazquez@phhp.ufl.edu
Kuhl
Emily A
EA
Shea
Julie Bishop
JB
Kirkness
Ann
A
Lemon
Jim
J
Whalley
David
D
Conti
Jamie B
JB
Sears
Samuel F
SF
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001007:Anxiety / Q000453:epidemiology* / Q000523:psychology*; D001293:Attitude to Death; D001315:Australia / Q000453:epidemiology; D001900:Boston / Q000453:epidemiology; D017147:Defibrillators, Implantable / Q000523:psychology* / Q000706:statistics & numerical data*; D004556:Electric Injuries / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D005431:Florida / Q000453:epidemiology; D006801:Humans; D038622:Internationality; D008875:Middle Aged; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016387:Women's Health