Age-Specific Differences in Women with Implantable Cardioverter Defibrillators: An International Multi Center Study

Authors: VAZQUEZ, LAUREN D.¹; KUHL, EMILY A.²; SHEA, JULIE BISHOP³; KIRKNESS, ANN⁴; LEMON, JIM⁵; WHALLEY, DAVID⁴; CONTI, JAMIE B.⁶; SEARS, SAMUEL F.⁷

Source: Pacing and Clinical Electrophysiology, Volume 31, Number 12, December 2008 , pp. 1528-1534(7)

Publisher: Wiley-Blackwell

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Abstract:

Background: Common psychological adjustment difficulties have been identified for groups of implantable cardioverter defibrillator patients, such as those who are young (<50 years old), have been shocked, and are female. Specific aspects and concerns, such as fears of death or shock and body image concerns, that increase the chance of distress, have not been examined in different aged female implantable cardioverter defibrillator (ICD) recipients. The aim of the study was to investigate these areas of adjustment across three age groups of women from multiple centers.

Methods: Eighty-eight female ICD patients were recruited at three medical centers: Shands Hospital at the University of Florida, Brigham and Women's Hospital in Boston, and Royal North Shore Hospital in Sydney, Australia. Women completed individual psychological assessment batteries, measuring the constructs of shock anxiety, death anxiety, and body image concerns. Medical record review was conducted for all patients regarding cardiac illnesses and ICD-specific data.

Results: Multivariate and univariate analyses of variance revealed that younger women reported significantly higher rates of shock and death anxiety (Pillai's F = 3.053, P = 0.018, η²_p= 0.067) and significantly greater body image concerns (Pillai's F = 4.198, P = 0.018, η²_p= 0.090) than middle- and older-aged women.

Conclusions: Women under the age of 50 appear to be at greater risk for the development of psychosocial distress associated with shock anxiety, death anxiety, and body image. Clinical-based strategies and interventions targeting these types of adjustment difficulties in younger women may allow for improved psychosocial and quality of life outcomes.

(PACE 2008; 31:1528-1534)

Keywords: defibrillation-ICD; quality of life

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1540-8159.2008.01223.x

Affiliations: 1: Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida 2: American Psychiatric Association, Division of Research and APIRE, Arlington, Virginia 3: Brigham and Women's Hospital, Harvard University, Boston, Massachusetts 4: Royal North Shore Hospital, St. Leonards, Australia 5: Health Psychology Unit, University of Technology, Sydney, Australia 6: Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida 7: Departments of Psychology and Cardiovascular Sciences, East Carolina University, Greenville, North Carolina

Publication date: 2008-12-01

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Age-Specific Differences in Women with Implantable Cardioverter Defibrillators: An International Multi Center Study

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