ICD Recipients´ technology readiness level and the relation to self-reported health: An exploratory study (Preprint)

Abstract

BACKGROUND Worldwide, every year approximately 200,000 Implantable Cardioverter Defibrillators (ICDs) are implanted on primary and secondary prophylactic indications. Approximately 20% of ICD recipients experience clinically significant psychological distress. Despite the acknowledged issue, there are currently no national or international ICD guidelines that specifically address the management of mental health issues as an integral component of rehabilitation programs which also ensures adequate psychological well-being and overall quality of life. Current practice is often aimed at enhancing the ICD recipients understanding of the underlying disease, prognosis, and preparing for a life with an ICD. There is a need for incorporating new elements, such as emotional distress, social interactions and prepare for the usage of technologies in the future course such as apps and virtual communication. This necessitates the development of innovative approaches in clinical care and rehabilitation without increasing the demand for additional hours from healthcare professionals. OBJECTIVE We aim to demonstrate how data from the Readiness for Health Technology Index (READHY), combined with socio-demographic characteristics and exploratory interviews, can be utilized to construct profiles of ICD recipients describing their ability to manage their condition, their need for support, and their digital health literacy. This aims to enhance healthcare professionals' understanding of different patient archetypes, serving as guidance in delivering personalized services tailored to the needs, resources, and capabilities of individual ICD recipients. METHODS Overall, 79 ICD recipients participated in a survey assessing technology readiness using the Readiness for Health Technology Index (READHY). The survey also collected sociodemographic data as age, sex, and educational level. Self-reported health was measured using a Likert scale. Cluster analysis categorized participants into profiles based on their READHY scores. Correlations between READHY scores and self-reported health were examined. Additionally, qualitative interviews with representatives from different readiness profiles provided deeper insights. RESULTS Four technology readiness profiles were found: Profile 1 (low digital health literacy insufficient on 5 scales), Profile 2 (sufficient in all dimensions), Profile 3 (consistently sufficient readiness in all dimensions), and Profile 4 (insufficient readiness in 9 dimension). Participants in Profile 4, characterized by the lowest readiness levels, were significantly younger and had lower self-reported health compared to those in Profile 3. A correlation analysis revealed that higher READHY scores were associated with better self-reported health across all dimensions. Qualitative interviews highlighted differences in self-management approaches and the experience of support between profiles, emphasizing the essential role of social support in ICD recipients' rehabilitation journeys. Two personas were created based on the characteristics from the highest and lowest created profile. CONCLUSIONS Employing the READHY instrument to create profiles of ICD recipients demonstrates how the instrument can be utilized to make health care professionals aware of specific needs within the group of ICD recipients.