The relationship between perceived support from healthcare professionals, shock anxiety and device acceptance in implantable cardioverter defibrillator recipients

Abstract

Purpose: The recipients acceptance of the implantable cardioverter defibrillator (ICD) can be influenced by several factors. One factor is perceived support from healthcare professionals during regular follow-up visits. Another factor is shock anxiety, i.e. the recipients concerns and fear related to possible future shocks. However, little is known about the relationship between perceived support from healthcare professionals, shock anxiety and device acceptance among the recipients. The purpose of this study is 1) to investigate the extent to which shock anxiety and perceived support from healthcare professional support is related to device acceptance and 2) to determine to what degree perceived support from health care professional moderates the relationship between shock anxiety and device acceptance in ICD recipients. Methods: A cross-sectional study comprising recipients (N-167, 80% male, mean age = 64 years) attending an outpatient device clinic completed standardized and validated questionnaires assessing perceived support from healthcare professionals, shock anxiety (the Florida Shock Anxiety Scale) and device acceptance (the Florida Patient Acceptance Survey). Demographic and clinical data were collected by self-report and from medical records in September-October 2010. The statistical analyses included descriptive statistics and multiple regression analyses. Results: The descriptive results indicated that 84.4% of the recipients reported high device acceptance. Regression analysis demonstrated that constructive support from healthcare professionals was positively associated with device acceptance (p<0.05) and moderated the negative relationship between shock anxiety and device acceptance (p<0.05). Non-constructive support and shock anxiety were statistically negatively associated with device acceptance (p<0.01). Conclusions: Healthcare professionals represent a valuable constructive support system that can enhance device acceptance among ICD recipients, partly by preventing shock anxiety from leading to poor device acceptance. On the other hand, the findings suggest that non-constructive communication on the part of healthcare professionals could hinder device acceptance.