title: Monitoring treatment expectations in patients with an implantable cardioverter-defibrillator using the EXPECT-ICD scale.
abstract: OBJECTIVE
  Patient treatment expectations may affect cardiac outcomes; however, till date, no validated instruments have been developed to monitor treatment expectations in patients with an implantable cardioverter-defibrillator (ICD). This study evaluates the predictive value of the newly developed 10-item EXPECtations Towards ICD therapy (EXPECT-ICD) in relation to anxiety, depression, and ICD related concerns 3 months post-implant.
  
  
  RESULTS
  Consecutive implanted ICD patients were included as part of the WEB-based distress management programme for ICD patients (WEBCARE) trial from six Dutch referral hospitals. The patients completed the baseline questionnaires briefly after ICD implantation. Information on clinical variables was captured from the patients' medical records. Patients' treatment expectations as assessed with the EXPECT-ICD questionnaire could best be represented with a two-factor model involving both negative (α = 0.84) and positive expectations (α = 0.77) with a score range of 0-20 for each factor. Negative treatment expectations were associated with higher levels of anxiety (β = 0.443; P < 0.001), depression (β = 0.506; P < 0.001), and ICD concerns (β = 0.428; P < 0.001) 3 months post-implant after controlling for demographic and clinical factors. Positive expectations were not related to any of the distress outcomes.
  
  
  CONCLUSIONS
  Negative expectations were associated with anxiety, depression, and ICD concerns 3 months post-implant. The current findings indicate that the EXPECT-ICD scale is a reliable, valid, and disease-specific measure of the treatment expectations in ICD patients. Future research needs to investigate whether addressing the patients' expectations might improve the outcome and the subjective well-being of ICD patients.
authors.affiliation: CoRPS-Department of Medical and Clinical Psychology, Tilburg University, 90153, 5000 LE Tilburg, The Netherlands.
authors.forename: Mirela
authors.initials: M
authors.lastname: Habibović
authors.affiliation: CoRPS-Department of Medical and Clinical Psychology, Tilburg University, 90153, 5000 LE Tilburg, The Netherlands Department of Cardiology, Thoraxcenter, Erasmus Medical Center, 2040, 3000 CA Rotterdam, The Netherlands Department of Psychology, University of Southern Denmark, DK-5230 Odense, Denmark Department of Cardiology, Odense University Hospital, DK-5000 Odense, Denmark sspedersen@health.sdu.dk.
authors.forename: Susanne S
authors.initials: SS
authors.lastname: Pedersen
authors.affiliation: CoRPS-Department of Medical and Clinical Psychology, Tilburg University, 90153, 5000 LE Tilburg, The Netherlands.
authors.forename: Krista C
authors.initials: KC
authors.lastname: van den Broek
authors.affiliation: CoRPS-Department of Medical and Clinical Psychology, Tilburg University, 90153, 5000 LE Tilburg, The Netherlands.
authors.forename: Johan
authors.initials: J
authors.lastname: Denollet
mesh_terms: D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology / Q000523:psychology*; D017147:Defibrillators, Implantable; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000523:psychology*; D004554:Electric Countershock / Q000009:adverse effects / Q000295:instrumentation* / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010361:Patients / Q000523:psychology*; D011594:Psychometrics; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
keywords: Implantable cardioverter-defibrillator; Psychological distress; Treatment expectations