title: Effect of psycho-educational interventions on quality of life in patients with implantable cardioverter defibrillators: a meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Implantable cardioverter defibrillators (ICD) were developed for primary and secondary prevention of sudden cardiac death. However, ICD recipients' mortality is significantly predicted by their quality of life (QOL). The aim of this meta-analysis was to evaluate the effects of psycho-educational interventions on QOL in patients with ICDs.
  
  
  METHODS
  We systematically searched PubMed, Medline, Cochrane Library, and CINAHL through April 2015 and references of relevant articles. Studies were reviewed if they met following criteria: (1) randomized controlled trial, (2) participants were adults with an ICD, and (3) data were sufficient to evaluate the effect of psychological or educational interventions on QOL measured by the SF-36 or SF-12. Studies were independently selected and their data were extracted by two reviewers. Study quality was evaluated using a modified Jadad scale. The meta-analysis was conducted using the Cochrane Collaboration's Review Manager Software Package (RevMan 5). Study heterogeneity was assessed by Q statistics and I2statistic. Depending on heterogeneity, data were pooled across trials using fixed-effect or random-effect modeling.
  
  
  RESULTS
  Seven randomized controlled trials fulfilled the inclusion and exclusion criteria, and included 1017 participants. The psycho-educational interventions improved physical component summary (PCS) scores in the intervention groups more than in control groups (mean difference 2.08, 95 % CI 0.86 to 3.29, p < 0.001), but did not significantly affect mental component summary (MCS) scores (mean difference 0.84, 95 % CI -1.68 to 3.35, p = 0.52).
  
  
  CONCLUSIONS
  Our meta-analysis demonstrates that psycho-educational interventions improved the physical component, but not the mental component of QOL in patients with ICDs.
authors.affiliation: Department of Nursing, Tri-Service General Hospital, No.325, Sec.2, Chenggong Rd., Taipei, 114, Taiwan. chiwenkao@ndmctsgh.edu.tw.|National Defense Medical Center, School of Nursing, No.161, Minchuan E. RD., Sec. 6, Taipei, 114, Taiwan. chiwenkao@ndmctsgh.edu.tw.
authors.forename: Chi-Wen
authors.initials: CW
authors.lastname: Kao
authors.affiliation: Department of Nursing, Ching Kuo Institute of Management and Health, No.336, Fu Hsin Rd., Keelung, Taiwan.
authors.forename: Miao-Yi
authors.initials: MY
authors.lastname: Chen
authors.affiliation: National Defense Medical Center, School of Nursing, No.161, Minchuan E. RD., Sec. 6, Taipei, 114, Taiwan.|Chung-Jen College of Nursing, Health Sciences and Management, No.161, Minchuan E. RD., Sec. 6, Taipei, 114, Taiwan.
authors.forename: Ting-Yu
authors.initials: TY
authors.lastname: Chen
authors.affiliation: Department of Nursing, Tri-Service General Hospital, No.325, Sec.2, Chenggong Rd., Taipei, 114, Taiwan.
authors.forename: Pai-Hui
authors.initials: PH
authors.lastname: Lin
mesh_terms: D000328:Adult; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D017147:Defibrillators, Implantable / Q000523:psychology*; D006305:Health Status Indicators; D006801:Humans; D015233:Models, Statistical; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000379:methods; D011613:Psychotherapy / Q000379:methods; D011788:Quality of Life / Q000523:psychology*; D016032:Randomized Controlled Trials as Topic