Abstract
This study is an attempt to provide an analysis of the influence of implementation of cognitive behavioral intervention (CBI) in patients after cardiovascular implantable electronic device (CIED) implantation on the quality of life following the procedure as well as the level of illness acceptance. The study group consisted of patients who underwent standard medical care related to CIED implantation and who additionally received CBI. Patients who received only standard medical care related to CIED implantation constituted a control group. CBI consisted of four sessions conducted over 30 (±3) days after the implantation. Demographic, clinicaland psychological factors were assessed.The Acceptance of Illness Scale (AIS) and EuroQol-5D (EQ-5D) were applied. In total, 128 patients (women: 36.7%, mean age 64.5 ± 8.9) were included in the study. The proposed cycle of four structured CBI meetings was well accepted by the patients, which is confirmed by their high turnout for these meetings. After six months, quality of life indices were significantly improved in cardiac electrotherapy recipients assigned to CBI, including: Visual Analogue Scale EQ-5D (80.2 ± 11.8 vs. 64.9 ± 14.3; p < 0.0001) and better acceptance of illness (AIS: 35.6 ± 4.3 vs. 28.7 ± 6.1; p < 0.0001). Implementation of CBI in patients after CIED implantation significantly improved indices of quality of life as well as illness acceptance, when compared to the control group of patients in standard care following electrotherapy. CBI showed multiple benefits in this population, as well as ensures the fulfilment of its expected therapeutic effect, while short duration of the intervention did not prolong the hospitalization itself.
Highlights
The development of medical technology has contributed to progress in cardiac arrhythmia and conduction disorders treatment, including a higher number of patients with cardiac implantable electronic devices worldwide, starting from the simplest pacemakers to implantable cardioverter-defibrillators
The proposed cycle of four structured cognitive behavioral intervention (CBI) meetings was well accepted by the patients, which is confirmed by their high turnout for these meetings
Quality of life indices were significantly improved in cardiac electrotherapy recipients assigned to CBI, including: Visual Analogue Scale EQ-5D (80.2 ± 11.8 vs. 64.9 ± 14.3; p < 0.0001) and better acceptance of illness (AIS: 35.6 ± 4.3 vs. 28.7 ± 6.1; p < 0.0001)
Summary
The development of medical technology has contributed to progress in cardiac arrhythmia and conduction disorders treatment, including a higher number of patients with cardiac implantable electronic devices worldwide, starting from the simplest pacemakers to implantable cardioverter-defibrillators. Depressive disorders were observed in 5.2% of patients with PCM and 6.5% of patients with ICD [4] The ambivalent feelings these patients experience as a result of perceived dependency on the device may lead to relative satisfaction and returning to full professional and social activity following the implantation procedure. These same feelings can become a source of an extremely unfavorable situation, i.e., of developing anxiety or depressive disorders, post-traumatic stress disorder or poor quality of life [5, 6]. This study is an attempt to provide an analysis of the influence of implementation of cognitive behavioral intervention (CBI) in patients after cardiovascular implantable electronic device (CIED) implantation on the quality of life (QoL) following the procedure as well as the level of illness acceptance
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