A comparative study of uncertainty, optimism and anxiety in patients receiving their first implantable defibrillator for primary or secondary prevention of sudden cardiac death

作者：Carroll Sandra L^*; Arthur Heather M

来源：International Journal of Nursing Studies, 2010, 47(7): 836-845.

DOI：10.1016/j.ijnurstu.2009.12.005

• Defibrillators
• Implantable
• Uncertainty
• Psychology
• Anxiety
• Nursing

Background Increasingly, patients are receiving implantable cardioverter defibrillators (ICDs) for prevention of sudden cardiac death ICDs are implanted for primary prevention (patients at risk for ventricular arrhythmia [PP]) and secondary prevention (patients who have had/survived l a sustained ventricular arrhythmia or cardiac arrest [SP]) Few prospective studies have examined psychosocial factors associated with these patients
Objectives To determine if patients receiving their first ICD for PP versus SP differed in uncertainty, anxiety, and optimism, before, 1 week, and 1 month after implant
Design Prospective. descriptive, correlational pilot
Participants and setting Fifteen PP and 15 SP patients receiving their first ICD were enrolled Mean ages (+/- SD) were 65 7 11 3 and 679, 7 7 respectively
Methods Mishel's Uncertainty in Illness Scale (MUIS-C), State-Trait Anxiety Inventory (STAI) and the Life Orientation Test (LOT-R) were taken pre-implant, at the first post-implant visit, and at 1 month Measures were compared using Student' t-tests and ANOVA Results Pre-implant, both groups had moderately high MUIS-C scores (mean SD, PP = 67 67 = 1336, SP = 70 27 6 80: t = 0 67, t(dr) = 28, p = 0 507) LOT-R scores were 15 67 3 8 for PP and 16 47 3 6 for SP, t = 059, t(df) = 28, p = 0 557 Pre-implant state anxiety scores were (mean PP = 37 40 +/- 10 0, SP = 37 73 +/- 136, t = 0076, t(df) = 28, p = 0 940) At 1-month PP patients had significantly lower uncertainty scores than the SP group (mean 62 33 +/- 4 17 versus 67 87 +/- 4 61, t = 3 45, t(df) = 28, p = 0 002)
A main effect for time, between pre-implant and 1-month, was found for uncertainty (F(2 56) = 326, p < 0 05) and state anxiety (F(2.56)= 361, p < 0 05), where both groups showed lower scores
Conclusion This study identified moderately high uncertainty in PP and SP patients prior to receiving their ICD. Though uncertainty was high, both groups reported an optimistic disposition and normal anxiety At 1-month, SP patients had higher uncertainty scores than PP patients. This post-intervention uncertainty among patients who experienced an

• 出版日期2010-7