Objectives:

To explore relationships between quality of life (QOL), coping strategies, anxiety, depression and perceived control in recipients living with an implantable cardioverter defibrillator (ICD) and compare those having received an ICD less or more than one year ago and those with a primary or secondary preventive indication.

Methods:

A cross-sectional, correlational design was used and 147 individuals (mean age 63 years, 121 men) who had lived with an ICD between 6 to 24 months completed Quality of Life Index-Cardiac version, Jalowiec Coping Scale, Hospital Anxiety and Depression Scale and Control Attitude Scale.

Results: 

A regression analysis showed that anxiety and depression were negatively correlated (ß=.16, p=0.025, ß=.30, p=0.012) respectively and perceived control was positively correlated (ß= .26, p=0.001) with overall QOL in ICD recipient 6-24 months after implant. A second regression analysis showed significant relationships between the dependent variable overall use of coping strategies and the anxiety (R2 adj = 0.213, F (4.132) = 10.186, p=0.001). More anxiety was correlated (β = 3.27, p=0.001) with increased use of coping strategies. Anxiety was quite common up to 2 years after ICD implant. Optimism was found to be the most frequently used coping strategy, but the recipients did not use a multitude of coping strategies. There was no relationship found between QOL and the use of different coping strategies. Time since implantation or the indication for receiving an ICD did not influence QOL, the use of coping strategies, symptoms of anxiety and depression or perceived control.

Conclusions:

Despite being a cost-effective, reliable and efficient implanted device for reducing the incidence of sudden cardiac death, the ICD can be associated with notable consequences in everyday life for the recipient. We suggest that follow-up with education and psychosocial support should be provided more intensively during the first six months after implantation and thereafter be tailored toward those recipients experiencing symptoms of depression and anxiety, a lower perceived control in life and a diminished QOL. By using screening tools to assess perceived control, anxiety and depression during follow up after implantation in the outpatient ICD clinic, recipients perceiving low control and mental strain in their everyday life can be identified and supportive interventions considered in order to increase their QOL. Coping strategies should be further explored in research and clinical practice in order to support ICD recipient to use the appropriate coping strategies.