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Randomized Controlled Trial
. 2022 Aug 10;22(1):369.
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

Cynthia M Dougherty  1 , Ana Carolina Sauer Liberato  2   3 , Megan M Streur  2 , Robert L Burr  2 , Ka Yee Kwan  2 , Tao Zheng  2 , Jon P Auld  2 , Elaine A Thompson  2
Affiliations
Randomized Controlled Trial

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 et al. BMC Cardiovasc Disord. .

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.

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Conflict of interest statement

The authors have no competing interests to disclose related to the manuscript.

Figures

Fig. 1
Fig. 1
Summary of Model Effects for Time, Group, ICD Indication Interactions for PCA, ICD shocks, Mental Health (SF-12 MCS), Outcome Expectations
See this image and copyright information in PMC

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