A Randomized Controlled Trial of Secondary Prevention of Anxiety and Distress in a German Sample of Patients With an Implantable Cardioverter Defibrillator
Autor: | Stefan M. Schulz, Volker Kühlkamp, Paul Pauli, Wolfgang R. Bauer, B. Schumacher, Alexander Crössmann, Hans Neuser, Oliver Ritter |
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Rok vydání: | 2010 |
Předmět: |
Adult
Counseling Male medicine.medical_specialty Adolescent Health Status medicine.medical_treatment Treatment outcome Aftercare law.invention Patient Education as Topic Quality of life Randomized controlled trial law Germany Surveys and Questionnaires Adaptation Psychological Secondary Prevention medicine Humans In patient Applied Psychology Aged Secondary prevention Depressive Disorder business.industry Age Factors Middle Aged Implantable cardioverter-defibrillator Anxiety Disorders Defibrillators Implantable Telephone Psychiatry and Mental health Distress Death Sudden Cardiac Treatment Outcome Quality of Life Physical therapy Anxiety Female medicine.symptom business Stress Psychological |
Zdroj: | Psychosomatic Medicine. 72:434-441 |
ISSN: | 0033-3174 |
Popis: | To evaluate a minimal, easy, accessible intervention targeting anxiety and reduced quality of life in patients with an implantable cardioverter defibrillator (ICD). An estimated 24% to 87% of patients experience anxiety, and 10% to 15% have reduced quality of life.A total of 119 ICD patients were assigned randomly to usual medical aftercare (n = 63) or additional psychological treatment (n = 56) comprising of written information on medical and psychological consequences of an ICD plus 6 months of individual phone counseling. Treatment efficacy was evaluated by comparing T0 (immediately after implantation) and T1 (6 months later) assessments.Although 75% of patients considered the program helpful, age moderated treatment efficacy. As indicated by triple interactions, only in the treatment group, anxiety (HADS-Anxiety, p.01), psychological distress (SCL-K-9, p.02), and somatic quality of life (SF-36-PCS, p.01) improved in ICD patients aged65 years but deteriorated in older patients (age, 65-75 years). Frequency of ICD discharges was associated with a symptom increase from T0 to T1 in all patients (HADS-Depression, CAQ-Avoidance, and ICD-Constraints; all p.05).Our findings confirm that psychological treatments cannot be expected to have uniformly positive effects in ICD patients. Our minimal intervention may have adequately addressed ICD-related concerns in younger patients but may have fostered problems in older patients with fewer concerns. Therefore, our findings warrant custom treatment with particular attention to the elderly as well as patients with frequent ICD discharges. |
Databáze: | OpenAIRE |
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