Physical function, psychological adjustment, and self-efficacy following sudden cardiac arrest and an initial implantable cardioverter defibrillator (ICD) in a social cognitive theory intervention: secondary analysis of a randomized control trial

Cynthia M Dougherty, Ana Carolina Sauer Liberato, Megan M Streur, Robert L Burr, Ka Yee Kwan, Tao Zheng, Jon P Auld, Elaine A Thompson, Cynthia M Dougherty, Ana Carolina Sauer Liberato, Megan M Streur, Robert L Burr, Ka Yee Kwan, Tao Zheng, Jon P Auld, Elaine A Thompson

Abstract

Background: Sudden cardiac arrest (SCA) survivorship results in unique issues in return to physical and psychological function. The purpose of the study was to compare recovery across the first year between SCA survivors and other arrhythmia patients who received a first-time implantable cardioverter defibrillator (ICD) for secondary prevention, participating in a social cognitive theory (SCT) intervention.

Methods: 168 (129 males, 39 females) who received an ICD for secondary prevention (SCA N = 65; other arrhythmia N = 103) were randomized to one of two study conditions: SCT intervention (N = 85) or usual care (N = 83). Outcomes were measured at baseline hospital discharge, 1, 3, 6, & 12 months: (1) Physical Function: Patient Concerns Assessment (PCA), SF-36 (PCS); (2) Psychological Adjustment: State Trait Anxiety (STAI), CES-D depression, SF-36 (MCS); (3) Self-Efficacy: Self-Efficacy (SCA-SE), Self-management Behaviors (SMB), Outcome Expectations (OE). Outcomes were compared over 12 months for intervention condition x ICD indication using general estimating equations.

Results: Participants were Caucasian (89%), mean age 63.95 ± 12.3 years, EF% 33.95 ± 13.9, BMI 28.19 ± 6.2, and Charlson Index 4.27 ± 2.3. Physical symptoms (PCA) were higher over time for SCA survivors compared to the other arrhythmia group (p = 0.04), ICD shocks were lower in SCA survivors in the SCT intervention (p = 0.01); psychological adjustment (MCS) was significantly lower in SCA survivors in the SCT intervention over 6 months, which improved at 12 months (p = 0.05); outcome expectations (OE) were significantly lower for SCA survivors in the SCT intervention (p = 0.008).

Conclusions: SCA survivors had greater number of physical symptoms, lower levels of mental health and outcome expectations over 12 months despite participation in a SCT intervention. Trial registration Clinicaltrials.gov: NCT04462887.

Keywords: Implantable cardioverter defibrillator; Intervention; Physical function; Psychological; Quality of life; Social cognitive theory; Sudden cardiac arrest; Symptoms.

Conflict of interest statement

The authors have no competing interests to disclose related to the manuscript.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Summary of Model Effects for Time, Group, ICD Indication Interactions for PCA, ICD shocks, Mental Health (SF-12 MCS), Outcome Expectations

References

    1. Sawyer KN, Camp-Rogers TR, Kotini-Shah P, Del Rios M, et al. Sudden cardiac arrest survivorship: a scientific statement from the AHA. Circulation. 2020;141:00–00. doi: 10.1161/Cir.00000000000747.
    1. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, Das SR, de Ferranti S, Després J-P, Fullerton HJ, et al. On behalf of the American heart association statistics committee and stroke statistics subcommittee. Heart disease and stroke statistics–2016 update: a re-port from the American heart association [published correction appears in Circulation. 2016;133:e599] Circulation. 2016;133:e38–e360.
    1. CARES Cardiac arrest registry to enhance survival. . Accessed 8/20/21.
    1. Gregoratos G, Abrams J, Epstein AE, et al. ACC/AHA/NASPE2002 guideline update for implantation of cardiac pacemakers antiarrhythmia devices—summary article: a report of the American college of cardiology/American heart association, task force on practice guidelines (ACC/AHA/NASPE committee to update the1998 pacemaker guidelines) J Am Coll Cardiol. 2002;40:1703–1719. doi: 10.1016/S0735-1097(02)02528-7.
    1. Callaway CW, Donnino MW, Fink EL, Geocadin RG, Golan E, Kern KB, Leary M, Meurer WJ, Peberdy MA, Thompson TM, et al. Part 8: post–cardiac arrest care: 2015 American heart association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care [published correction appears in Circulation. 2017;136:e197] Circulation. 2015;132(suppl 2):S465–S482.
    1. Dougherty CM, Lewis FM, Thompson ET, Baer JD, Kim W. Short term efficacy of a telephone intervention after ICD implantation. Pacing Card Electrophysiol. 2004;27:1594–1602. doi: 10.1111/j.1540-8159.2004.00691.x.
    1. Dougherty CM, Thompson EA, Lewis FM. Long term outcomes of a nursing intervention after an ICD. Pacing Card Electrophysiol. 2005;28:1157–1167. doi: 10.1111/j.1540-8159.2005.09500.x.
    1. Al-Khatib SM, Stevenson WG, Ackerman MJ, Bryant WJ, Callans DJ, Curtis AB, Deal BJ, Dickfeld T, Field ME, Fonarow GC, Gillis AM, Granger CB, Hammill SC, Hlatky MA, Joglar JA, Kay GN, Matlock DD, Myerburg RJ, Page RL. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American college of cardiology/American heart association task force on clinical practice guidelines and the heart rhythm society. J Am Coll Cardiol. 2018;72(14):e91–e220. doi: 10.1016/j.jacc.2017.10.054.
    1. Carpenter CR, Bassett ER, Fischer GM, Shirshekan J, Galvin JE, Morris JC. Four sensitive screening tools to detect cognitive dysfunction in geriatric emergency department patients: Brief Alzheimer’s Screen, Short Blessed Test, Ottawa 3DY, and the caregiver-completed AD8. Acad Emerg Med Off J Soc Acad Emerg Med. 2011;18:374–384. doi: 10.1111/j.1553-2712.2011.01040.x.
    1. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psych Rev. 1977;84:191–215. doi: 10.1037/0033-295X.84.2.191.
    1. Dougherty CM, Benoliel JQ, Bellin C. Domains of nursing intervention after sudden cardiac arrest and automatic internal cardioverter defibrillator implantation. Heart Lung J Crit Care. 2000;29(2):79–86. doi: 10.1067/mhl.2000.105759.
    1. Dougherty CM, Johnson-Crowley NR, Lewis FM, Thompson EA. Theoretical development of nursing interventions for sudden cardiac arrest survivors using social cognitive theory. Adv Nurs Sci. 2001;20(1):78–86. doi: 10.1097/00012272-200109000-00009.
    1. Dougherty CM, Pyper GP, Frasz HA. Description of a nursing intervention after ICD implantation. Heart Lung J Acute Crit Care. 2004;33(3):183–190. doi: 10.1016/j.hrtlng.2004.01.003.
    1. Jenkins LS, Dunbar SB, Hawthorne MH. Patient concerns before and the first 9-months after ICD implantation. Circulation. 1997;96(8):745.
    1. Ware J, Kosinski M, Keller SD. A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34:220–233. doi: 10.1097/00005650-199603000-00003.
    1. Spielberger C, Gorsuch R, Lushene R. Manual for the state-trait anxiety inventory (self-evaluation questionnaire) Palo Alto, CA: Consulting Psychologists; 1970.
    1. Radloff LS. The CES-D scale: a self-report of depression scale for re-search in the general population. Appl Psychol Meas. 1977;1:385–401. doi: 10.1177/014662167700100306.
    1. Dougherty CM, Johnston SK, Thompson EA. Reliability and validity of the self efficacy expectations and outcome expectations after ICD implantation scales. Appl Nurs Res. 2007;20(3):116–124. doi: 10.1016/j.apnr.2007.04.004.
    1. Allison PD. Missing data techniques for structural equation modeling. J Abnorm Psychol. 2003;112(4):545–557. doi: 10.1037/0021-843X.112.4.545.
    1. Rothman JK. No adjustments are needed for multiple comparisons. Epidemiology. 1990;1(1):43–46. doi: 10.1097/00001648-199001000-00010.
    1. Wyrwich KW, Tierney WM, Babu AN, Kroenke K, Wolinsky FD. A comparison of clinically important differences in health-related quality of life for patients with chronic lung disease, asthma, or heart disease. Health Serv Res. 2005;40(2):577–592. doi: 10.1111/j.1475-6773.2005.0l374.x.
    1. Elliott VJ, Rodgers DL, Brett SJ. Systematic review of quality of life and other patient-centered outcomes after cardiac arrest survival. Resuscitation. 2011;82:247–256. doi: 10.1016/j.resuscitation.2010.10.030.
    1. Saner H, Rodriguez EB, Kummer-Bangerter A, Schüppel R, von Planta M. Quality of life in long-term survivors of out-of-hospital cardiac arrest. Resuscitation. 2002;53(1):7–13. doi: 10.1016/S0300-9572(02)00002-3.
    1. Harve H, Tiainen M, Poutiainen E, Maunu M, Kajaste S, Roinet RO, Silvast TT. The functional status and perceived quality of life in long-term survivors of out-of-hospital cardiac arrest. Acta Anaesthesiol Scand. 2007;51:206–209. doi: 10.1111/j.1399-6576.2006.01214.x.
    1. Green CR, Botha JA, Tiruvoipati R. Cognitive function, quality of life and mental health in survivors of out-of-hospital cardiac arrest: a review. Anaesth Intensive Care. 2015;43(5):568–576. doi: 10.1177/0310057X1504300504.
    1. Haydon G, van der Riet P, Maguire J. Survivors’ quality of life after cardiopulmonary resuscitation: an integrative review of the literature. Scand J Caring Sci. 2017;31:6–26. doi: 10.1111/scs.12323.
    1. Haywood KL, Pearson N, Morrison LJ, Castrén M, Lilja G, Perkins GD. Assessing health-related quality of life (HRQoL) in survivors of out-of-hospital cardiac arrest: a systematic review of patient-reported outcome measures. Resuscitation. 2018;123:22–37. doi: 10.1016/j.resuscitation.2017.11.065.
    1. Walsh TS, Salisbury LG, Merriweather JL, Boyd HA, Griffith DM, Huby G, Kean S, Mackenzie SJ, Krishan A, Lewis SC, et al. RECOVER Investigators. Increased hospital-based physical rehabilitation and information provision after intensive care unit discharge: the RECOVER randomized clinical trial. JAMA Intern Med. 2015;175:901–910. doi: 10.1001/jamainternmed.2015.0822.
    1. Gamper G, Willeit M, Sterz F, Herkner H, Zoufaly A, Hornik K, Havel C, Laggner AN. Life after death: posttraumatic stress disorder in survivors of cardiac arrest—prevalence, associated factors, and the influence of sedation and analgesia. Crit Care Med. 2004;32:378–383. doi: 10.1097/01.CCM.0000108880.97967.C0.
    1. Dougherty CM. Psychological reactions and family adjustment in shock versus no shock groups after implantation of internal cardioverter defibrillator. Heart Lung. 1995;24:281–291. doi: 10.1016/S0147-9563(05)80071-8.
    1. Kamphuis HCM, Verhoeven N, de Leeuw R, Derksen R, Hauer R, Winnubst J. ICD: a qualitative study of patient experience the first year after implantation. J Clin Nurs. 2004;13:1008–1016. doi: 10.1111/j.1365-2702.2004.01021.x.
    1. Lilja G, Nilsson G, Nielsen N, Fribergd H, Hassager C, Koopmans M, Martin KA, Mellinghoff MJ, Pelosi P, Wanscher M, Wise MP, Östman I, Cronberg T. Anxiety and depression among out-of-hospital cardiac arrest survivors. Resuscitation. 2015;97:68–75. doi: 10.1016/j.resuscitation.2015.09.389.
    1. Baptist AP, Ross JA, Yang Y, Song PX, Clark NM. A randomized controlled trial of a self-regulation intervention for older adults with asthma. J Am Geriatr Soc. 2013;61:747–753. doi: 10.1111/jgs.12218.
    1. Kovar PA, Allegrante JP, MacKenzie CR, Peterson MG, Gutin B, Charlson ME. Supervised fitness walking in patients with osteoarthritis of the knee. A randomized, controlled trial. Ann Intern Med. 1992;116:529–534. doi: 10.7326/0003-4819-116-7-529.
    1. Gray CM, Hunt K, Mutrie N, Anderson AS, Treweek S, Wyke S. Weight management for overweight and obese men delivered through professional football clubs: a pilot randomized trial. Int J Behav Nutr Phys Act. 2013;10:121. doi: 10.1186/1479-5868-10-121.
    1. Furber S, Butler L, Phongsavan P, Mark A, Bauman A. Randomised controlled trial of a pedometer based telephone intervention to increase physical activity among cardiac patients not attending cardiac rehabilitation. Patient Educ Couns. 2010;80:212–218. doi: 10.1016/j.pec.2009.11.012.
    1. Dougherty CM, Thompson EA, Kudenchuk PJ. Patient plus partner trial: a randomized controlled trial of 2 interventions to improve outcomes after an initial implantable cardioverter-defibrillator. Heart Rhythm. 2019;16(3):453–459. doi: 10.1016/j.hrthm.2018.10.011.

Source: PubMed

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

3
Abonnere