Recipients' of implanted cardioverter‐defibrillators actual and perceived adaptation: a review of the literature

Abstract

ICD recipients have reported multiple physical and psychological adjustment issues that require further study to determine gravity and duration. Clinicians must be familiar with adjustment difficulty expressed by ICD recipients in order to facilitate appropriate tailored interventions. The findings of this literature review emphasize a need for support groups for ICD recipients and their partners; behavioral and sexual counseling; continued education after discharge; and a supportive healthcare provider who is knowledgeable in device adjustment issues. The research indicates a need for a post-ICD implantation plan, and data are available for the design testing of tailored interventions.

Sexual Counseling for Individuals With Cardiovascular Disease and Their Partners

“…83 Patients may be prevented from discussing sexual issues because of fear of healthcare providers' attitudes toward homosexuality or bisexuality. The association between CVD and psychological issues such as fear, 25,84,85 anxiety, 79,86,87 and depression 86,88,89 has been well documented. There is limited evidence, however, specifically related to sexual counseling and psychological concerns, yet depression and anxiety can have detrimental effects on sexual activity when comorbid CVD is present and should be assessed in patients before they engage in sexual activity.…”

Uncertainty is a major concern for patients with implantable cardioverter defibrillators

“…[5][6][7] Living with an ICD, often in combination with a chronic heart disease, affects the individual's life situation and encompasses some or all aspects of life. [8][9][10][11] Worry may arise regarding health and the technical function of the ICD, the prognosis of the underlying heart disease, the welfare of the family, and how to cope with the future. 1,11,12 In addition, ICD recipients need to assimilate a large amount of new information about the medical condition, pharmacologic treatment, risk of having a new or recurrent ventricular arrhythmia, technical aspects of the device, and details regarding the implantation procedure and follow-up routines.…”

“…[8][9][10][11] Worry may arise regarding health and the technical function of the ICD, the prognosis of the underlying heart disease, the welfare of the family, and how to cope with the future. 1,11,12 In addition, ICD recipients need to assimilate a large amount of new information about the medical condition, pharmacologic treatment, risk of having a new or recurrent ventricular arrhythmia, technical aspects of the device, and details regarding the implantation procedure and follow-up routines. 6,9,13 The device itself is a constant reminder that something dangerous or unpleasant could occur at any time.…”

“…14,17 Specific ICD-related concerns, such as fear of shocks, device malfunction, thoughts of death, and embarrassment, influence how the recipients live their daily life. 11,17,18 Anxiety, depression, and stress are other emotions that control life and seem more severe in recipients who have received ICD shocks. 19,20 The daily life of an ICD recipient is influenced not only by the underlying heart disease and the device but also by the adaptation to a changed life situation as a result of ICD implantation.…”

Toward a More Materialistic Medicine: The Value of Authentic Materialism Within Current and Future Medical Practice

“…Aware that their hearts are so sick that their lives depend on the permanent implantation of a battery-powered generator that might shock them at any time, and that itself requires a lifetime of specialized monitoring, a substantial proportion of patients experience anxiety, depression, and impaired quality of life. [40][41][42] Although research results are not consistent, attempts to isolate predisposing factors seem to point toward the individual patient's characterology-some persons cope better with this challenge than others-and the number of shocks received from the device. 43 Patients commonly have a fear of being shocked, which can be very painful.…”