Changes in health status and quality of life and the impact of uncertaintyin patients who survive life-threatening arrhythmias

OBJECTIVE: The purpose of this study was to describe the changes in percept ion of health status and quality of life from before treatment to 6 months after and the impact of uncertainty on these variables I : in survivors of life-threatening arrhythmia. DESIGN AND SETTING: A descriptive correlational design at a large urban tea ching hospital. MEASURES: We measured health status, quality of life; and uncertainty befor e treatment and 6 months after a life-threatening arrhythmia. RESULTS: Survivors included 66 men and 15 women, 41 of whom received pharma cologic therapy and 36 of whom received an implantable cardioverter defibri llator (ICD), completed the Medical Outcomes F Survey (SF-36), Ferrans and Powers Quality of Life Index: (QLI), and the Mishel Uncertainty in Illness Scale (MUIS-C) before treatment and 6 months after. There were significant improvements in the men tal and physical health composite summaries as meas ured by the SF36 (P < .01). Conversely, there were significant reductions i n the overall score and specifically in socioeconomic and psychological/spi ritual quality of life domains as measured by the QLI (P < .05).:An increas ed perception of uncertainty was related to decreased perception of health status and quality of life at both measurement times, with higher correlati ons 6 months later. CONCLUSIONS: Survivors demonstrated improvements in perceived health status , although this did not appear to translate into improvements in the subjec tive domains of quality of life. The overall quality of life and the domain s of psychological/spiritual state and socioeconomic status were lower 6 mo nths after a life-threatening arrhythmia. Uncertainty had a significant imp act on these perceptions, identifying an area for nursing interventions.