The assessment of stress reactions of patients with implanted defibrillators

Abstract

Background. Although they save life, implantable defibrillators have psychological side effects and increase the number of patients who experience anxiety, depressive symptoms and, in extreme cases, post-traumatic stress disorder (PT SD). Escalation of PT SD symptoms depends on patients’ ability to cope with stress. Objectives . The aim of this study was to assess the reactions of patients after defibrillator implantation, and their ways to cope with stress, as well as to analyze the relationship between the ways of coping with stress and PT SD symptoms. Material and methods. The study was conducted using the Mini-Cope, the Impact of Event Scale-Revised (IES-R), and the author’s questionnaire. It involved 111 patients with implanted defibrillators at the mean age of 60 years, including 88 (79.3%) men. The majority of the patients had secondary education – 38 (34.2%) and were married – 85 (76.6%). 51 (45.9%) were one year after defibrillator implantation. Results. It was demonstrated that 49 (44.1%) of the surveyed experienced intracardiac discharges, out of whom 8 (17.1%) went through an ‘electrical storm’. This group obtained higher PT SD scores in all three IES-R domains comparing to those without implanted defibrillators. The most common strategy to cope with stress was acceptance of the situation and searching for emotional support. Conclusions . 1. Intracardiac discharges are the vital problem of patients after defibrillator implantation. 2. Searching for emotional support and acceptance of the situation are the most common strategies to cope with stress. 3. There is a relationship between PT SD symptoms occurring in patients after implantation of a defibrillator and their strategies to cope with stress.

Keywords

• PT SD
• implantable cardioverter–defibrillator
• stress