Document Detail


Effect of a psychoeducational intervention on depression, anxiety, and health resource use in implantable cardioverter defibrillator patients.
MedLine Citation:
PMID:  19796343     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Psychological responses have been reported for some patients after the insertion of an implantable cardioverter defibrillator (ICD). This study tested the effects of a psychoeducational intervention on anxiety, depressive symptoms, functional status, and health resource use during the first year after ICD implantation.
METHODS: ICD patients (n = 246) were randomized to usual care (UC), group (GRP), or telephone counseling (TC) intervention that included education, symptom management, and coping skill training. Participants were 58 +/- 11 years, 73% men, and 23% minorities. Anxiety (State-Trait Anxiety Inventory [STAI]), depressive symptoms (Beck Depression Inventory II [BDI-II]), and functional status (Duke Activity Status Inventory [DASI]) were measured at baseline and after 1, 3, 6, and 12 months. Health resource use and disability days were tracked. Analyses were repeated-measures analysis of covariance to assess Group x Time effects,chi(2)for percentage with clinically significant anxiety and depression at each time point, and logistic regression.
RESULTS: All groups experienced decreased anxiety and depressive symptoms over the 12 months; GRP intervention had lower STAI (P = 0.03) than UC at 3 months. Logistic regression revealed group differences for predicted probability of having depressive symptoms at 12 months (UC = 0.31, GRP = 0.17, TC = 0.13, P = 0.03). UC had greater calls to providers at 1 and 6 months (P < 0.05) and more sick/disability days at 12 months (P = 0.01) than intervention groups.
CONCLUSIONS: A psychoeducational intervention reduced anxiety and depressive symptoms early after ICD implant, lowered probability of depressive symptoms at 1 year, and decreased disability days/calls to providers. These findings support further study and clinical use of both group and telephone interventions to yield better psychological outcomes after ICD implant.
Authors:
Sandra B Dunbar; Jonathan J Langberg; Carolyn M Reilly; Bindu Viswanathan; Frances McCarty; Steven D Culler; Marian C O'Brien; William S Weintraub
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  32     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-02     Completed Date:  2009-12-09     Revised Date:  2013-05-31    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1259-71     Citation Subset:  IM    
Affiliation:
Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia 30022, USA. Sbdunba@emory.edu
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MeSH Terms
Descriptor/Qualifier:
Anxiety / epidemiology,  prevention & control*,  psychology
Comorbidity
Defibrillators, Implantable / psychology,  utilization*
Depression / epidemiology,  prevention & control*,  psychology
Female
Georgia / epidemiology
Health Resources
Humans
Longitudinal Studies
Male
Middle Aged
Patient Education as Topic / statistics & numerical data*
Prevalence
Program Evaluation
Psychotherapy / statistics & numerical data*
Quality of Life / psychology*
Self Care
Treatment Outcome
Grant Support
ID/Acronym/Agency:
R01 5187//PHS HHS; R01 NR005187-04/NR/NINR NIH HHS
Comments/Corrections
Comment In:
Int J Group Psychother. 2011 Jul;61(3):463-8   [PMID:  21728710 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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