Effect of a psychoeducational intervention on depression, anxiety, and health resource use in implantable cardioverter defibrillator patients.
Pacing Clin Electrophysiol
; 32(10): 1259-71, 2009 Oct.
Article
em En
| MEDLINE
| ID: mdl-19796343
ABSTRACT
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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ansiedade
/
Psicoterapia
/
Qualidade de Vida
/
Educação de Pacientes como Assunto
/
Desfibriladores Implantáveis
/
Depressão
Tipo de estudo:
Clinical_trials
/
Evaluation_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Pacing Clin Electrophysiol
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
Estados Unidos