title: Emotions and health: findings from a randomized clinical trial on psychoeducational nursing to patients with implantable cardioverter defibrillator.
abstract: BACKGROUND
  Serious illness will inevitably lead to a fundamental emotional reaction. Traditionally, in interventional treatment or rehabilitation trials, the psychological status of patients with implantable cardioverter defibrillators has been evaluated with anxiety and depression as outcome measures. In caring for these patients, the aim of nursing is to help patients manage life with complex heart disease. The early detection and management of negative emotional response might prevent the development of pathological conditions such as depression.
  
  
  OBJECTIVE
  The aims of this study were to (a) describe the trajectory of primary emotions over time in patients with implantable cardioverter defibrillators and (b) examine the potential effects of psychoeducational nursing on primary emotions.
  
  
  METHODS
  During the inclusion period (October 2007 to November 2009), 196 patients with implantable cardioverter defibrillator were randomized (1:1) to rehabilitation versus usual care. Rehabilitation consisted of a psychoeducational nursing component and an exercise training component. This article concerns phase 1, psychoeducational nursing, guided by a theory of nursing, Rosemary Rizzo Parses Human Becoming Practice Methodologies. The outcome measure is the Emotions and Health Scale. The scale consists of 8 primary emotions: joy, agreeableness, surprise, fear, sadness, disgust, anger, and anticipation.
  
  
  RESULTS
  Mean (SD) age was 58 (13) years, and 79% of the participants were men. Significant improvements were found in primary emotional responses over time (P < .05) when combining groups. However, no difference in emotional intensity was found between the groups after 3 months of psychoeducational nursing intervention (P > .05).
  
  
  CONCLUSIONS
  Primary emotions are affected after implantable cardioverter defibrillator implantation. Improvements over time were found. However, it was not possible to detect any effect of a short-term psychoeducational nursing intervention. Evaluating the primary emotions might be a good way for nurses to monitor patients' psychological outcomes because the instrument is sensitive to changes over a short period. Further development of early psychoeducational nursing interventions for patients with implantable cardioverter defibrillators is needed.
authors.affiliation: Selina Kikkenborg Berg, PhD Postdoc, The Heart Centre, University of Copenhagen, Denmark. Louise Støier, RN Clinical Nurse Specialist, Department of Cardiology, Bispebjerg University Hospital, Copenhagen NV, Denmark. Philip Moons, PhD Professor, Centre for Health Services and Nursing Research, KU Leuven, University of Leuven, Belgium. Ann-Dorthe Zwisler, PhD Senior Researcher, The Heart Centre, University of Copenhagen, Denmark. Per Winkel, MD Senior Researcher, The Copenhagen Trial Unit, Centre for Clinical Intervention Research Unit 3344, Copenhagen University Hospital, Denmark. Preben Ulrich Pedersen, PhD Professor, Faculty of Health Sciences, University of Aalborg, Denmark.
authors.forename: Selina
authors.initials: S
authors.lastname: Kikkenborg Berg
authors.forename: Louise
authors.initials: L
authors.lastname: Støier
authors.forename: Philip
authors.initials: P
authors.lastname: Moons
authors.forename: Ann-Dorthe
authors.initials: AD
authors.lastname: Zwisler
authors.forename: Per
authors.initials: P
authors.lastname: Winkel
authors.forename: Preben
authors.initials: P
authors.lastname: Ulrich Pedersen
mesh_terms: D000223:Adaptation, Psychological; D001007:Anxiety / Q000517:prevention & control; D017147:Defibrillators, Implantable / Q000523:psychology*; D003863:Depression / Q000517:prevention & control; D004644:Emotions; D005260:Female; D018939:Holistic Nursing; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic