Abstract
OBJECTIVE
To examine the relationships among personal factors (demographic variables and trait optimism); situational factors (ejection fraction, functional status, history of sudden cardiac arrest); coping and appraisal processes; and mood disturbance in patients hospitalized for recurrent ventricular dysrhythmia before the insertion of an implantable cardioverter defibrillator (ICD).
DESIGN
Descriptive and correlational.
SETTING
Five community and tertiary care hospitals in the southeast and midwest.
PATIENTS
Eighty-four men and 17 women (aged 24 through 79) scheduled to receive an initial implant of an ICD. VARIABLES AND MEASURES: Trait optimism measured by the Life Orientation Tool; coping measured by the Jalowiec Coping Scale; threat-and-challenge appraisal measured by the Meaning in Illness Questionnaire; functional status measured by the Heart Failure Functional Status Inventory; and total mood disturbance measured by the Profile of Mood States.
RESULTS
Hierarchical regression analysis revealed that factors of age, sex, optimism, functional status, and history of sudden cardiac arrest accounted for 47% of the variance in the total mood disturbance score (F = 7.44, df = 11.68, p = 0.00) with female sex, and less trait optimism, higher threat appraisal, and more use of evasive coping behavior as significant predictors.
CONCLUSIONS
These findings can be used to identify patients with recurrent ventricular dysrhythmia who are potentially at risk for mood disturbance in the acute care setting before ICD insertion. Nursing interventions to address these factors can be developed and tested. Longitudinal studies on the response to ICDs should include assessment of preinsertion affective state.
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