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Liberato ACS, Raitt MH, Zarraga IGE, MacMurdy KS, Dougherty CM. Health-Related Quality of Life in the Spironolactone to Reduce ICD Therapy (SPIRIT) Trial. Clin Nurs Res 2021; 31:588-597. [PMID: 34362264 DOI: 10.1177/10547738211036817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To describe health related quality of life (HRQOL) and symptoms in the SPIRIT trial and determine effects of implantable cardioverter defibrillator (ICD) shocks on HRQOL over 24 months. Ninety participants aged 66 ± 10 years, 96% men, 75% with NYHA class II, with an ICD were randomized to spironolactone 25 mg (N = 44) or placebo (N = 46). HRQOL was measured every 6 months for 24 months using: Patient Concerns Assessment (PCA), Short Form Health Survey-Veterans Version (SF-36V), and Kansas City Cardiomyopathy Questionnaire (KCCQ). Linear mixed modeling compared changes in HRQOL over-time and ANCOVA compared HRQOL between those getting an ICD shock or not. Over 24-months, there were no differences in HRQOL between the spironolactone versus placebo groups. Those with at least one ICD shock reported significantly lower HRQOL and more symptoms at 6- and 24-months. Patients receiving one or more ICD shocks reported significant reductions in HRQOL and higher symptoms.
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Affiliation(s)
| | - Merritt H Raitt
- VA Portland Health Care System, OR, USA.,Oregon Health and Science University, Portland, USA
| | | | - Karen S MacMurdy
- VA Portland Health Care System, OR, USA.,Oregon Health and Science University, Portland, USA
| | - Cynthia M Dougherty
- University of Washington, Seattle, USA.,VA Puget Sound Health Care System, Seattle, WA, USA
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2
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Timal RJ, de Gucht V, Rotmans JI, Hensen LCR, Buiten MS, de Bie MK, Putter H, Schalij MJ, Rabelink TJ, Jukema JW. The impact of transvenous cardioverter-defibrillator implantation on quality of life, depression and optimism in dialysis patients: report on the secondary outcome of QOL in the randomized controlled ICD2 trial. Qual Life Res 2021; 30:1605-1617. [PMID: 33606179 PMCID: PMC8178151 DOI: 10.1007/s11136-020-02744-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2020] [Indexed: 02/06/2023]
Abstract
RATIONALE The impact of prophylactic implantable cardioverter-defibrillator (ICD) implantation on the psychological well-being of patients on dialysis is unknown. OBJECTIVE We aimed to identify the effect of primary ICD implantation on quality of life (QoL), mood and dispositional optimism in patients undergoing dialysis. METHODS AND RESULTS We performed a prespecified subanalysis of the randomized controlled ICD2 trial. In total, 177 patients on chronic dialysis, with an age of 55-81 years, and a left ventricular ejection fraction of ≥ 35%, were included in the per-protocol analysis. Eighty patients received an ICD for primary prevention, and 91 patients received standard care. The Short Form-36 (SF-36), Geriatric Depression Scale-15 (GDS-15), Revised Life Orientation Test (LOT-R) questionnaires were administered prior to ICD implantation (T0), and at 1-year follow-up (T1) to assess QoL, depression and optimism, respectively. The patients were predominantly male (76.0%), with a median age of 67 years. Hemodialysis was the predominant mode of dialysis (70.2%). The GDS-15 score difference (T1 - T0) was 0.5 (2.1) in the ICD group compared with 0.3 (2.2) in the control group (mean difference - 0.3; 95% CI - 1.1 to 0.6; P = 0.58). The LOT-R score difference was - 0.2 (4.1) in the ICD group compared with - 1.5 (4.0) in the control group (mean difference - 1.1 (0.8); 95% CI - 2.6 to 0.4; P = 0.17). The mean difference scores of all subscales of the SF-36 were not significantly different between randomization groups. CONCLUSIONS In our population of patients on dialysis, ICD implantation did not affect QoL, mood or dispositional optimism significantly during 1-year follow-up. CLINICAL TRIAL REGISTRATION Unique identifier: ISRCTN20479861. http://www.controlled-trials.com .
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Affiliation(s)
- Rohit J Timal
- Department of Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.
| | - Veronique de Gucht
- Department of Health and Medical Psychology, Leiden University, Leiden, The Netherlands
| | - Joris I Rotmans
- Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Liselotte C R Hensen
- Department of Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands
| | - Maurits S Buiten
- Department of Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands
| | - Mihaly K de Bie
- Department of Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.,Department of Cardiology, Treant Zorggroep, Hoogeveen, The Netherlands
| | - Hein Putter
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Martin J Schalij
- Department of Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands
| | - Ton J Rabelink
- Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands
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3
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Rosi IM, Bombardieri F, Steri D, Sternativo M, Rancati S. "Those Plates That Save Me": Experiences of Italian Patients With Implantable Cardioverter Defibrillator. Clin Nurs Res 2020; 30:616-624. [PMID: 33103473 DOI: 10.1177/1054773820968036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This study aimed to investigate and understand the experiences and feelings lived by people with an ICD. Qualitative study, semi-structured interviews were conducted with a sample of 16 patients, during the annual follow-up. A hermeneutical analysis of the interviews was carried out to identify the themes. Four main themes were classified: "My heart falls asleep," highlighting a reduced awareness of the pathology and ICD installation; "But what is this thing. . .?" underlining the lack of information and fears related to the device and its functioning; "I cannot hug the microwave" which describes the changes brought about by the surgery; "And with this one I am alright for the rest of my life", involving hopes and life expectations. This study highlighted the patients' need for major support from health professionals while processing their new life conditions.
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Affiliation(s)
- Ivana Maria Rosi
- Healthcare Professionals Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,University of Milan, Italy
| | - Francesca Bombardieri
- Healthcare Professionals Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Daniele Steri
- Healthcare Professionals Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Mimma Sternativo
- Healthcare Professionals Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefania Rancati
- Healthcare Professionals Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,University of Milan, Italy
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Guo X, Tripp C, Huber NL, Hou C, Lv R, Li J, Liang T, Sears SF. Patient reported outcomes and quality of life in Chinese patients with implantable cardioverter defibrillators ✰. Heart Lung 2020; 50:153-158. [PMID: 32553697 DOI: 10.1016/j.hrtlng.2020.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 05/01/2020] [Accepted: 05/11/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Patient reported outcomes in Implantable Cardioverter Defibrillator (ICD) patients can describe the experience of living with heart disease and with an ICD. However, very little is known about patient outcomes among Chinese patients which may limit effective patient discussions and interventions for these patients. The purposes of this study were to examine device related experiences (e.g., device acceptance, shock anxiety) in Chinese ICD patients and identify potential variables that influence health related quality of life (HRQOL) and to compare HRQOL outcomes to healthy and heart failure populations. METHODS This study used a cross-sectional research design with serially recruited ICD patients (N = 100) from clinics in China. Participants completed surveys including: the 12-Item Short-Form Health Survey Questionnaire (SF-12), Florida Patient Acceptance Survey (FPAS), Florida Shock Anxiety Scale (FSAS), Type D Scale (DS-14), and general information questionnaire. RESULTS Participants were 100 ICD patients in China with a mean age of 53.32(SD = 13.70). The mean scores of the SF-12 physical component summary (PCS) and mental component summary (MCS)of ICD patients (43.55 and 47.07, respectively) were lower than the Chinese general population (P<0.001) and general health, social functioning, and role emotional scores were lower than chronic heart failure patients (P<0.001). Multiple linear regression analysis indicated that LVEF, positive shock history, age and shock anxiety were significant predictors of physical function and accounted for 24.5% of the adjusted variance. Type D personality, shock history, and shock anxiety were predictors of the mental health component and accounted for 25.9% of the variance. Shock history, age, type D personality, and shock anxiety significantly predicted device acceptance (FPAS-Total) and accounted for 32% of variance. CONCLUSIONS ICD patients reported health outcomes were generally lower than the Chinese general population and patients with heart failure in relation to general health, social functioning, and role emotional. Both generic and disease specific HRQOL were influenced by both medical and psychosocial predictors. This suggests that current Western society based comprehensive models of patient HRQOL and patient care needs may extend to Chinese patients with ICDs.
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Affiliation(s)
- Xijuan Guo
- Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Connor Tripp
- Department of Psychology, East Carolina University, Greenville, North Carolina, USA
| | - Nichelle L Huber
- Department of Psychology, East Carolina University, Greenville, North Carolina, USA
| | - Cuihong Hou
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rong Lv
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Li
- Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Tao Liang
- School of Nursing Peking Union Medical College, Beijing, China.
| | - Samuel F Sears
- Department of Psychology, East Carolina University, Greenville, North Carolina, USA; Department of Cardiovascular Sciences, East Carolina University, Greenville, North Carolina USA
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Perez JM, Alessi C, Kittleson MD, Linares-Villalba S, Engel-Manchado J. Psychometric Properties of the Spanish Version of the Functional Evaluation of Cardiac Health Questionnaire "FETCH-Q™" for Assessing Health-related Quality of Life in Dogs with Cardiac Disease. Top Companion Anim Med 2020; 39:100431. [PMID: 32482290 DOI: 10.1016/j.tcam.2020.100431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 03/12/2020] [Accepted: 03/12/2020] [Indexed: 10/24/2022]
Abstract
To evaluate the psychometric properties of the Spanish version of the "FETCH-Q™", 228 dogs with cardiovascular diseases were included. After forward and back translation of the original questionnaire, nonexperts, ethologists and veterinary colleagues evaluated the content's validity through feedback. For criteria validity, the total score was correlated with the heart disease/failure class. For construct validity, the overall quality of life of the dog and the results obtained in each question was correlated. The reliability of the questionnaire was assessed using the Cronbach's alpha coefficient. To evaluate the test-retest validity the intra-class correlation coefficient and Wilcoxon signed-rank test were used. A good agreement with the original questionnaire was evident. For construct validity, the questionnaire obtained r > 0.09 to < 0.82. The criterion validity was appropriate and the correlation was rho = 0.82, with an effect size of 0.55 (P < 0.05). Cronbach's alpha coefficient was (α = 0.89). The test-retest assessment revealed adequate repeatability (correlation coefficient = 0.87; P < .001). There was no difference in the owner responses to the questionnaire at baseline and 2 weeks later in dogs with stable cardiac disease (P > .05). This study supports the validity of psychometric properties of the Spanish version of the functional evaluation of cardiac health questionnaire "FETCHSV2-Q™" to assess Health-related Quality of Life in dogs with cardiovascular disease in clinical settings and research.
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Affiliation(s)
- Jeff M Perez
- Advanced Veterinary Centre - المستوصف البيطرى المتقدمة, Doha Expy, Doha, Qatar.
| | - Chiara Alessi
- Department of Animal health, University of Caldas, Manizales, Colombia
| | - Mark D Kittleson
- Department of Medicine and Epidemiology, University of California, Davis, Davis, CA, USA
| | | | - Javier Engel-Manchado
- Cardiology service, Veterinary Clinic-Teaching Hospital, CEU Cardenal Herrera University, Valencia, España
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Thrysoee L, Thorup CB, Rasmussen TB, Borregaard B, Christensen AV, Juel K, Ekholm O, Vamosi M, Banke A, Berg SK. Patient-reported outcomes at hospital discharge among patients with arrhythmia: Results from the national DenHeart survey. Eur J Cardiovasc Nurs 2019; 19:248-259. [PMID: 31744327 DOI: 10.1177/1474515119888813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Patient-reported outcomes are important predictors of mortality, cardiovascular events and hospitalisation in patients with cardiac diseases, but differences in patient-reported outcomes between groups of patients with arrhythmia have not yet been investigated. AIMS To describe and compare patient-reported outcomes at discharge among patients with different types of cardiac arrhythmia and to examine the associations between demographic characteristics, inhospital factors and patient-reported outcomes. METHODS Data were derived from the national DenHeart study including patient-reported outcomes from the following questionnaires: the hospital anxiety and depression scale (HADS), HeartQoL, short form 12 (SF-12), current health status (EQ-5D), brief illness perception questionnaire (B-IPQ) and the Edmonton symptom assessment scale (ESAS). Clinical and demographic data were obtained from national registers. Multiple linear and logistic regression models were used to investigate the associations between the potential risk factors and the patient-reported outcomes. RESULTS A total of 4251 patients diagnosed with arrhythmia completed the questionnaire. Across the arrhythmia subgroups, some differences were observed. In general, patient-reported outcome scores were worst among patients with 'ventricular arrhythmia' (e.g. highest depression scores and highest prevalence of feeling unsafe at discharge). Regression analysis revealed that longer hospital stay, female gender, being unmarried and having a short education were significantly associated with poor health for almost all arrhythmia subgroups. CONCLUSION Differences exist in self-reported health, quality of life and symptom burden across arrhythmia groups with patients with ventricular arrhythmia reporting poorer patient-reported outcomes. Longer hospital stay, female gender, being unmarried and having a low level of education were significantly associated with worse outcomes among the total population.
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Affiliation(s)
- Lars Thrysoee
- Department of Cardiology, Odense University Hospital, Denmark.,Department of Health Sciences, Department of Clinical Research, University of Southern Denmark, Denmark
| | - Charlotte Brun Thorup
- Department of Cardiology and Department of Cardiothoracic Surgery and Clinical Nursing Research Unit, Aalborg University Hospital, Denmark
| | | | - Britt Borregaard
- Department of Health Sciences, Department of Clinical Research, University of Southern Denmark, Denmark.,Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Denmark
| | | | - Knud Juel
- National Institute of Public Health, University of Southern Denmark, Denmark
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Denmark
| | - Marianne Vamosi
- Section for Nursing Department of Public Health, Aarhus University, Department of Cardiology, Aarhus University Hospital, Denmark
| | - Ann Banke
- Department of Cardiology, Odense University Hospital, Denmark.,Department of Health Sciences, Department of Clinical Research, University of Southern Denmark, Denmark
| | - Selina Kikkenborg Berg
- The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Denmark.,National Institute of Public Health, University of Southern Denmark, Denmark
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Buys R, Goessler KF. The HeartQoL questionnaire is valid for use in implantable cardioverter defibrillator recipients.. What does this mean for clinical practice? Eur J Prev Cardiol 2017; 25:139-141. [PMID: 29154679 DOI: 10.1177/2047487317743047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Roselien Buys
- 1 Department of Cardiovascular Science, Faculty of Medicine - KU Leuven, Belgium
| | - Karla F Goessler
- 2 Department of Physical Education, State University of Londrina, Brazil
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Yardımcı T, Mert H. Web-Based Intervention to Improve Implantable Cardioverter Defibrillator Patients’ Shock-Related Anxiety and Quality of Life: A Randomized Controlled Trial. Clin Nurs Res 2017; 28:150-164. [DOI: 10.1177/1054773817741427] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In spite of its effectiveness, implantable cardioverter defibrillator (ICD) patients face psychological problems such as shock-related anxiety due to device shocks. The aim of this study was to evaluate whether a web-based intervention program for ICD patients would reduce shock-related anxiety and improve quality of life compared with usual care. This was a randomized controlled trial study including a total of 76 patients. Data were collected using Turkish versions of the Florida Shock Anxiety Scale and Short Form Health Survey (SF-36) at 0 (baseline), 3, and 6 months. Following intervention, there was a significant decrease in shock anxiety levels of patients and a statistically significant increase in social functioning, role-physical, mental health, vitality, and bodily pain subdimensions of SF-36. While no statistically significant difference was found between groups in terms of summary scores of SF-36, our results suggest that web-based interventions can be useful for ICD patients.
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Affiliation(s)
| | - Hatice Mert
- Dokuz Eylül University Faculty of Nursing, Izmir, Turkey
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Wong MFF. Factors associated with anxiety and depression among patients with implantable cardioverter defibrillator. J Clin Nurs 2016; 26:1328-1337. [PMID: 27859926 DOI: 10.1111/jocn.13637] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2016] [Indexed: 12/01/2022]
Abstract
AIMS AND OBJECTIVES To identify factors associated with anxiety and depression of patients with implantable cardioverter defibrillators. BACKGROUND Implantable cardioverter defibrillator is effective to increase survival from life-threatening arrhythmias, but it lowers health-related quality of life. Anxiety and depression had significant negative association with health-related quality of life. However, knowledge about factors associated with these two negative emotions in this specific population is inadequate. DESIGN A cross-sectional descriptive design was conducted. Secondary analysis was performed to address the aim. METHODS A convenience sampling of patients with implantable cardioverter defibrillators was performed. Anxiety and depression were measured by the Hospital Anxiety and Depression Scale through face-to-face interview. RESULTS Stepwise multivariable regression results showed that older age (aged 60-69 and ≥70: B = 2·08 and 3·31, p = 0·039 and <0·001), self-care dependence (B = 3·47, p < 0·001), being married (B = -2·21, p = 0·004) and having ischaemic heart disease (B = -1·80, p = 0·008) were significantly associated with depression. However, there was no significant factor associated with anxiety. CONCLUSIONS Factors associated with depression among patients with implantable cardioverter defibrillator are identified. Older age (aged ≥60) and more self-care dependence have positive, but being married and having ischaemic heart disease have negative association with depression. Strategies to reduce psychological distress are highlighted. RELEVANCE TO CLINICAL PRACTICE The study findings direct the care to improve health-related quality of life by reducing and controlling vulnerabilities arising from depression. Patients who are older people (≥aged 60) and more self-care dependent perceive higher depression. Nursing strategies are suggested to reduce depression especially for those who are older people and more self-care dependent. Early screening is essential to provide immediate care for reducing vulnerabilities arising from depression. Performing comprehensive assessment for self-care ability and providing adequate assistance are crucial. Family involvement may reduce depression through providing physical and psychosocial support.
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Affiliation(s)
- Mei Fung Florence Wong
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
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