Abstract 321: Illness Perceptions and Readiness for Discharge Are Associated with Psychological Symptoms in Cardiac Arrest Survivors with Good Neurologic Recovery

Abstract

Introduction: Understanding the development of psychological symptoms post-arrest is a major research gap. In qualitative studies, cardiac arrest survivors report being poorly equipped to face the numerous sequelae upon returning home, which could in turn exacerbate acute psychological symptoms from the initial cardiac arrest event. In this study, we examined associations between illness perceptions (i.e. cognitive and emotional appraisals of illness and recovery), readiness for discharge, and provider-patient communication with psychological symptoms in cardiac arrest survivors with good neurologic recovery. Methods: We distributed an online survey to cardiac arrest survivors who were members of the Sudden Cardiac Arrest Foundation. Survivors completed the Brief Illness Perception Questionnaire (B-IPQ), Readiness for Hospital Discharge Scale (RHDS), Questionnaire for the Quality of Provider-Patient Interactions (QQPPI), PTSD Checklist-5 (PCL-5), and Patient Health Questionnaire-4 (PHQ-4) which has anxiety and depression subscales. Three multiple regression models examined associations between B-IPQ, RHDS, and QQPPI scores with PCL-5 and PHQ-4 anxiety and depression sores, adjusted for age, sex, time since arrest, self-reported understanding of cardiac arrest and post-arrest symptoms at discharge, self-reported memory at discharge, functional status via the Lawton Instrumental Activities of Daily Living scale, pre-arrest Charlson Comorbidity Index, and income. Results: We obtained full data from 163 survivors (mean age: 50.1 years, 50.3% women, 95.5% white, mean time since arrest: 63.9 months). More threatening illness perceptions (β: .57, p < .01) and lower readiness for discharge (β: -.22, p = .01) were associated with greater posttraumatic stress symptoms. More threatening illness perceptions was associated with greater anxiety (β: .53, p < .01) and depression (β: .5, p < .01) symptoms. Conclusions: Illness perceptions and readiness for discharge were associated with psychological symptoms in cardiac arrest survivors. Future studies should examine the feasibility of in-hospital assessment of survivors’ illness perceptions, readiness for discharge, and psychological symptoms.