MOOD DISTURBANCE IN PATIENTS WITH RECURRENT VENTRICULAR DYSRHYTHMIA BEFORE INSERTION OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR

OBJECTIVE: To examine the relationships among personal factors (demogr aphic variables and trait optimism); situational factors (ejection fra ction, functional status, history of sudden cardiac arrest); coping an d appraisal processes; and mood disturbance in patients hospitalized f or recurrent ventricular dysrhythmia before the insertion of an implan table cardioverter defibrillator (ICD). DESIGN: Descriptive and correl ational. SETTING: Five community and tertiary care hospitals in the so utheast and midwest. PATIENTS: Eighty-four men and 17 women (aged 24 t hrough 79) scheduled to receive an initial implant of an ICD. VARIABLE S AND MEASURES: Trait optimism measured by the Life Orientation Tool; coping measured by the Jalowiec Coping Scale; threat-and-challenge app raisal measured by the Meaning in Illness Questionnaire; functional st atus measured by the Heart Failure Functional Status Inventory; and to tal mood disturbance measured by the Profile of Mood States. RESULTS: Hierarchical regression analysis revealed that factors of age, sex, op timism, functional status, and history of sudden cardiac arrest accoun ted 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, h igher threat appraisal, and more use of evasive coping behavior as sig nificant predictors. CONCLUSIONS: These findings can be used to identi fy patients with recurrent ventricular dysrhythmia who are potentially at risk for mood disturbance in the acute care setting before ICD ins ertion. Nursing interventions to address these factors can be develope d and tested. Longitudinal studies on the response to ICDs should incl ude assessment of preinsertion affective state.