Abstract 20211: Perceived Control in Patients With Implantable Cardioverter Defibrillator

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Introduction: Perceived control is essential to both the physical and psychological aspects of quality of life (QOL) among individuals with chronic conditions, and it is possible to increase perceived control with appropriate intervention. Little is known about the relationship between perceived control and QOL in implantable cardioverter defibrillator (ICD) recipients

Purpose: To determine predictors of perceived control and the relationship between perceived control and QOL in ICD recipients

Methods: A total of 274 ICD recipients (27% female, age 61 ± 13 years) from the US (n=201) and Australia (n= 73) completed the Control Attitude Scale-Revised to measure perceived control, and completed self-reported measures on potential correlates of perceived control (i.e., depressive symptoms, anxiety, social support , and ICD concerns. The EuroQol-5D was used to measure QOL in 5 dimensions: pain, mobility, self-care, usual activity, and anxiety/depression. Each dimension has 3 levels: no problems, some problems, and extreme problems. The outcome variable in each dimension was dichotomized to “No problem/Problem”. Multiple regression analysis was used to determine predictors of perceived control. Separate logistic regression models were used to examine the association between perceived control and each of the QOL dimensions.

Results: Lower perceived control was predicted by poor social support (β=0.19, p<.01) and higher levels of anxiety (β=-0.18, p<.05), depressive symptoms (β=-0.46, p<.001) and ICD concerns (β=-0.25, p<.001) (F = 16.52, R2 = .32, p < .001). There were no differences in perceived control level between the US and Australia. Perceived control was independently associated with better QOL (p<0.5). For each unit increase in the level of perceived control, the odds of problems in the dimensions of pain (OR .91, p<.001), mobility (OR .95, p<.01), self-care (OR .90, p<.01), usual activity (OR .89, p<.001), and anxiety/depression (OR .90, p<.001) were significantly lower, controlling for covariates.

Conclusions: Interventions such as psycho-educational counseling that target patients’ ICD concerns and psycho-social factors before and after ICD insertion are warranted to improve perceived control and, in turn, QOL in ICD recipients

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