The ICD shock and stress management program: A randomized trial of psychosocial treatment to optimize quality of life in ICD patients

Samuel F. Sears, Lauren D.Vazquez Sowell, Emily A. Kuhl, Adrienne Kovacs, Eva R. Serber, Eileen Handberg, Shawn M. Kneipp, Issam Zineh, Jamie B. Conti

Research output: Contribution to journalArticle

84 Citations (Scopus)

Abstract

Background: Implantable cardioverter defibrillator (ICD) patients potentially face significant psychological distress because of their risk for life-threatening arrhythmias and the occurrence of ICD shock. Methods: The purpose of this study was to test an ICD stress and shock management program delivered in either a six-week format or a one-day workshop format. This intervention was aimed at reducing psychological (anxiety) and physiological (salivary cortisol) markers of distress in ICD patients. Secondary endpoints included measures of quality of life (QOL) and patient acceptance of device therapy, as well as biological mediators of inflammation (TNFα and IL-6). Results: The ICD stress and shock management program resulted in the reduction of anxiety (P < 0.05) and cortisol levels (P < 0.05) in both the six weekly sessions format and the one-day workshop. Measures of anxiety decreased more rapidly with weekly intervention (P = 0.05). Both formats also resulted in a significant increase in patient acceptance of the ICD (P < 0.01). Follow-up assessment from posttreatment (T2) to four-month follow-up (T4) indicated no significant change in depression scores from posttreatment for all groups taken together, but there was a significant group by time effect, such that the workshop group displayed an increase in depression scores from T2 (M = 8.71, SD = 4.39) to T4 (M = 13.57, SD = 11.90), P < 0.05. Conclusions: These results suggest that structured interventions for shocked ICD patients involving ICD education and cognitive-behavioral strategies can reduce psychological distress and improve quality of life, regardless of format.

Original languageEnglish (US)
Pages (from-to)858-864
Number of pages7
JournalPACE - Pacing and Clinical Electrophysiology
Volume30
Issue number7
DOIs
StatePublished - Jul 1 2007
Externally publishedYes

Fingerprint

Implantable Defibrillators
Shock
Quality of Life
Education
Anxiety
Therapeutics
Psychology
Hydrocortisone
Depression
Inflammation Mediators
Cardiac Arrhythmias
Interleukin-6
Equipment and Supplies

Keywords

  • Implantable cardioverter defibrillator
  • Psychological
  • Quality of life
  • Shock
  • Stress

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

The ICD shock and stress management program : A randomized trial of psychosocial treatment to optimize quality of life in ICD patients. / Sears, Samuel F.; Sowell, Lauren D.Vazquez; Kuhl, Emily A.; Kovacs, Adrienne; Serber, Eva R.; Handberg, Eileen; Kneipp, Shawn M.; Zineh, Issam; Conti, Jamie B.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 30, No. 7, 01.07.2007, p. 858-864.

Research output: Contribution to journalArticle

Sears, Samuel F. ; Sowell, Lauren D.Vazquez ; Kuhl, Emily A. ; Kovacs, Adrienne ; Serber, Eva R. ; Handberg, Eileen ; Kneipp, Shawn M. ; Zineh, Issam ; Conti, Jamie B. / The ICD shock and stress management program : A randomized trial of psychosocial treatment to optimize quality of life in ICD patients. In: PACE - Pacing and Clinical Electrophysiology. 2007 ; Vol. 30, No. 7. pp. 858-864.
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AU - Kovacs, Adrienne

AU - Serber, Eva R.

AU - Handberg, Eileen

AU - Kneipp, Shawn M.

AU - Zineh, Issam

AU - Conti, Jamie B.

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AB - Background: Implantable cardioverter defibrillator (ICD) patients potentially face significant psychological distress because of their risk for life-threatening arrhythmias and the occurrence of ICD shock. Methods: The purpose of this study was to test an ICD stress and shock management program delivered in either a six-week format or a one-day workshop format. This intervention was aimed at reducing psychological (anxiety) and physiological (salivary cortisol) markers of distress in ICD patients. Secondary endpoints included measures of quality of life (QOL) and patient acceptance of device therapy, as well as biological mediators of inflammation (TNFα and IL-6). Results: The ICD stress and shock management program resulted in the reduction of anxiety (P < 0.05) and cortisol levels (P < 0.05) in both the six weekly sessions format and the one-day workshop. Measures of anxiety decreased more rapidly with weekly intervention (P = 0.05). Both formats also resulted in a significant increase in patient acceptance of the ICD (P < 0.01). Follow-up assessment from posttreatment (T2) to four-month follow-up (T4) indicated no significant change in depression scores from posttreatment for all groups taken together, but there was a significant group by time effect, such that the workshop group displayed an increase in depression scores from T2 (M = 8.71, SD = 4.39) to T4 (M = 13.57, SD = 11.90), P < 0.05. Conclusions: These results suggest that structured interventions for shocked ICD patients involving ICD education and cognitive-behavioral strategies can reduce psychological distress and improve quality of life, regardless of format.

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