A nursing intervention to enhance acceptance of implantable cardioverter defibrillators : a randomized pilot study

Abstract

Background: Patients may experience anxiety and reduced quality of life after implantable cardioverter defibrillator (ICD) device implantation. Objective: To assess the feasibility, acceptability, and preliminary efficacy of the Approach Caring and Cognitive Behavioural (PRO-CARE) intervention, aimed at improving ICD device acceptance and psycho-functional outcomes one month after implantation. Methods: The pilot study involved 30 patients randomized to the intervention (IG) or control (CG) groups. The three encounters of the PRO-CARE intervention addressed patient-specific ICD concerns by focusing on beliefs leading to lower device acceptance and psycho-functional outcomes. Results: Thirteen (87%) of the 15 IG patients received all three encounters. The intervention was both feasible and acceptable. Although not statistically significant, mean scores on ICD device acceptance, shock, and general anxiety favoured the IG. Conclusions: Further research is needed to replicate results from this pilot study, but our observations suggest that nurses need to assess ICD patient anxiety and to tailor their interventions accordingly.