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

doi:10.1186/s12872-022-02782-8

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

BMC Cardiovasc Disord. 2022 Aug 10;22(1):369. doi: 10.1186/s12872-022-02782-8.

Authors

Cynthia M Dougherty¹, Ana Carolina Sauer Liberato^{2

3}, Megan M Streur², Robert L Burr², Ka Yee Kwan², Tao Zheng², Jon P Auld², Elaine A Thompson²

Affiliations

¹ School of Nursing, Biobehavioral Nursing and Health Informatics, University of Washington, 1959 NE Pacific Street, Box 357266, Seattle, WA, 98195, USA. cindyd@uw.edu.
² School of Nursing, Biobehavioral Nursing and Health Informatics, University of Washington, 1959 NE Pacific Street, Box 357266, Seattle, WA, 98195, USA.
³ Evidera PPD, London, England, UK.

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.

Publication types

Randomized Controlled Trial
Research Support, N.I.H., Extramural

MeSH terms

Aged
Death, Sudden, Cardiac / etiology
Death, Sudden, Cardiac / prevention & control
Defibrillators, Implantable*
Emotional Adjustment
Female
Heart Arrest*
Humans
Male
Middle Aged
Psychological Theory
Self Efficacy

Associated data

ClinicalTrials.gov/NCT04462887

Abstract

Publication types

MeSH terms

Associated data

Grants and funding