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American Journal of Critical Care. 2006;15: 389-398
Copyright © 2006 by the American Association of Critical-Care Nurses.
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Quality of Life and Psychological Status of Patients With Implantable Cardioverter Defibrillators

By Sue Ann Thomas, RN, PhD, Erika Friedmann, PhD, Chi-Wen Kao, RN, MS, Pia Inguito, RN, MS, Matthew Metcalf, PharmD, Frances J. Kelley, RN, PhD, FNP and Steven S. Gottlieb, MD.. From the Schools of Nursing (SAT, EF, C-WK, PI), Pharmacy (MM), and Medicine (SSG), University of Maryland, Baltimore, Md, and the School of Nursing and Health Studies, Georgetown University, Washington, DC (FJK).

• Background Implantable cardioverter defibrillators reduce mortality in patients at high risk for sudden cardiac death and in patients with heart failure. Patients with defibrillators often experience psychological distress and poor quality of life, which can potentiate pathological processes that increase the risk for sudden cardiac death. To achieve the full benefits of the defibrillators, patients must maintain their psychological status and quality of life.

• Objectives To review the research on psychological status and quality of life of patients with implantable cardioverter defibrillators and suggest nursing interventions to improve the patients’ health.

• Method Searches of PubMed were used to find articles on depression, anxiety, and quality of life in patients with implantable cardioverter defibrillators.

• Results Poor quality of life is associated with anxiety and depression in patients with implantable cardioverter defibrillators. Discharges of the devices have adverse consequences for patients’ psychological status and quality of life. Younger patients are at highest risk for psychological distress and poor quality of life after implantation. Longitudinal research would facilitate determining the course of the changes in psychological status and quality of life during the time patients have the defibrillators. More intensive intervention may be necessary for the most vulnerable recipients: patients who are young, have experienced shocks, and are in psychological distress.

• Conclusions Poor quality of life and depression are common in patients with implantable cardioverter defibrillators. Nursing interventions to reduce psychological distress and improve quality of life may reduce morbidity and mortality in these patients. Additional research is needed to determine effective interventions.




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Copyright © 2006 by the American Association of Critical-Care Nurses.