SHOxABILITY : Ability and avoidance of daily activity behaviors in ICD patients

ECU Author/Contributor (non-ECU co-authors, if there are any, appear on document)

Katherine Elizabeth Cutitta (Creator)

Institution

East Carolina University (ECU )

Web Site: http://www.ecu.edu/lib/

Advisor

Samuel F. Sears

Abstract: Background: Implantable Cardioverter Defibrillator (ICD) shocks terminate potentially life-threatening arrhythmias. ICD shock may alter patient behavior via patients attempting to avoid daily activities or increasing heart rate. Patients are aware of which activities they have the ability to perform but may choose to avoid these behaviors. The current study entitled SHOxABILITY examined ICD patients' ability and avoidance of progressively exertive behaviors. In addition the factors of sex age shock and shock anxiety were examined for differences on avoidance behaviors. Methods: Four hundred forty-three ICD patients across the United States were surveyed using an online measure. The survey included the Duke Activity Status Index (DASI) and the Florida Shock Anxiety Scale (FSAS) and was designed to provide a brief descriptive assessment of individual ICD experiences. Results: As expected many patients reported being unable to participate in more physically exertive activities such as strenuous athletic exertion (68.8%) sex (35.4%) and running a short distance (49.0%). Avoidance rates were also relatively high as patients who reported being able to participate in these activities also reported avoiding them (i.e. strenuous athletics 55.1%). Similarly the majority of patients reported ability to engage in sexual activity (64.6%) but many chose to avoid sexual activity (51.0%). Women reported greater shock anxiety than men. Patients aged 65 and older reported significantly greater levels of activity avoidance than younger individuals. Patients who are older reported significantly lower shock anxiety. Having experienced prior ICD shock did not affect the reported level of activity avoidance. As shock history increases greater levels of shock anxiety were reported. Multiple reasons were reported for avoiding including fear of shock fear of heart rate increase doctor instruction no desire and an "other" option. The effects of sex age and shock indicated greater shock anxiety in patients with shock history as well as younger patients. Conclusion: Many ICD patients experience behavioral limitations due to both a perceived inability and preference to avoid exertive activities particularly strenuous athletic exertion. Clinical and research attention to ICD patient activity levels and reasons for avoidance may improve daily functioning and return to pre-implant levels of activity.

Additional Information

Publication

Thesis

Date: 2012

Keywords

Behavioral sciences, Clinical psychology, Health sciences, avoid, Behavior, ICD, shock, sudden cardiac arrest

Subjects

Implantable cardioverter-defibrillators--United States

Heart--Diseases--Patients--United States--Attitudes

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