PSYCHOLOGICAL REACTIONS AND FAMILY ADJUSTMENT IN SHOCK VERSUS NO SHOCK GROUPS AFTER IMPLANTATION OF INTERNAL CARDIOVERTER-DEFIBRILLATOR

Purpose: The purpose of this study was to compare psychological reacti ons and family adjustment after sudden cardiac arrest (SCA) and intern al cardioverter defibrillator (ICD) implantation in survivors who did and did not experience defibrillatory shocks the first year of recover y. Methods: Data were collected as part of a longitudinal prospective study that examined patient and family adjustment after SCA. SCA survi vors and one family member per patient were interviewed and completed questionnaires three times within the first year (hospital discharge, 6 months, and 12 months) after SCA.Sample: Fifteen SCA survivors (13 m en and 2 women) between the ages of 30 and 74 (mean 57 years) and one respective family member, usually the spouse, (mean age 53 years) part icipated. All SCA survivors had had primary ventricular fibrillation o utside the hospital, had automatic defibrillators implanted white hosp italized, and were monitored for 1 year. Results: Participants were di vided into shock and no shock groups based on activation of their ICD the first year. The mean number of shocks received in the shock group survivors was 26, with a range of 3 to 100. Anxiety, depression, anger , and stress levers were higher for both survivors and their family me mbers in the group that received defibrillator shocks. Denial was high throughout the entire year in all survivors. Dyadic adjustment and fa mily coping were not found to be significantly different between the n o shock and shock groups. A trend toward reduction in family social su pport and dyadic satisfaction was noted in both groups with time. Conc lusions: Both SCA survivors and their family members experience more p sychological distress in the first year after ICD implantation if the defibrillator fires. Families in both shock and no shock groups report lower levels of family support and marital satisfaction the first yea r after SCA and ICD implantation.