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Perceived support from healthcare professionals, shock anxiety and post-traumatic stress in implantable cardioverter defibrillator recipients

Authors

  • Ingvild M Morken MSc, RN,

    PhD Student, Corresponding author
    1. Department of Cardiology, Stavanger University Hospital, Stavanger, Norway
    2. Department of Health Studies, University of Stavanger, Stavanger, Norway
    • Correspondence: Ingvild M Morken, PhD Student, Department of Cardiology, Stavanger University Hospital and Department of Health Studies, University of Stavanger, Stavanger, Norway. Telephone: +4751525496; +4791510483.

      E-mail: moin@sus.no

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  • Edvin Bru PhD,

    Professor
    1. Department of Health Studies, University of Stavanger, Stavanger, Norway
    2. Centre for Behavioural Research, University of Stavanger, Stavanger, Norway
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  • Tone M Norekvål PhD, RN,

    Associate Professor
    1. Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
    2. Institute of Medicine, University of Bergen, Bergen, Norway
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  • Alf I Larsen MD, PhD,

    Professor
    1. Department of Cardiology, Stavanger University Hospital, Stavanger, Norway
    2. Institute of Medicine, University of Bergen, Bergen, Norway
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  • Thormod Idsoe PhD,

    Psychologist and Professor
    1. Centre for Behavioural Research, University of Stavanger, Stavanger, Norway
    2. Norwegian Institute of Public Health, Oslo, Norway
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  • Bjørg Karlsen PhD, RN

    Associate Professor
    1. Department of Health Studies, University of Stavanger, Stavanger, Norway
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Abstract

Aims and objectives

To investigate (1) the extent to which shock anxiety and perceived support from healthcare professionals are related to post-traumatic stress disease (PTSD) symptoms and (2) the extent to which perceived support from healthcare professionals moderates the relationship between shock anxiety and PTSD symptoms in implantable cardioverter defibrillator recipients. An additional aim was to describe the level of PTSD symptoms and perceptions of support from healthcare professionals.

Background

Studies examining PTSD symptoms among implantable cardioverter defibrillator recipients are still sparse. In addition, little is known about how perceived support from healthcare professionals is related to PTSD symptoms.

Design

Cross-sectional survey design.

Methods

Recipients (n = 167) with implantable cardioverter defibrillator attending an outpatient device clinic completed questionnaires assessing shock anxiety, PTSD symptoms and perceived support from healthcare professionals.

Results

The results indicated that between ten and 15% of the recipients experienced moderate to severe symptoms of PTSD. Although a majority perceived constructive support from healthcare professionals, 12% perceived nonconstructive support. Regression analysis demonstrated that shock anxiety and perceived nonconstructive support from healthcare professionals had a statistically significant (p < 0·01) association with PTSD symptoms. Moreover, the results suggest that associations between shock anxiety and PTSD symptoms were significantly (p < 0·01) moderated by perceived nonconstructive support from healthcare professionals. Young age, short time since implantation and secondary prevention indication were also significantly associated with PTSD symptoms.

Conclusions

The results indicate that nonconstructive support from healthcare professionals can increase the tendency to develop PTSD symptoms, particularly in those who experience shock anxiety.

Relevance to clinical practice

Healthcare professionals should pay more attention to the way in which they communicate information to the recipients during follow-up visits. Clinically based strategies and interventions targeting shock anxiety and PTSD symptoms should be carried out.

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