Evaluation of an Internet-based intervention for ICD patients with elevated symptoms of posttraumatic stress disorder.


Journal

Pacing and clinical electrophysiology : PACE
ISSN: 1540-8159
Titre abrégé: Pacing Clin Electrophysiol
Pays: United States
ID NLM: 7803944

Informations de publication

Date de publication:
05 2019
Historique:
received: 02 08 2018
revised: 08 01 2019
accepted: 02 03 2019
pubmed: 9 3 2019
medline: 4 12 2019
entrez: 9 3 2019
Statut: ppublish

Résumé

To date, treatment to reduce posttraumatic stress disorder (PTSD) symptoms in implantable cardioverter defibrillator (ICD) patients has been limited by lack of symptom recognition, lack of provider referrals, barriers to treatment access, and inadequate evidence base of treatment effectiveness in this population. Participants were 46 patients with ICDs (17 paired) with elevated PTSD symptoms who were recruited in electrophysiology clinics at community and university hospitals as well as ICD support forums. Participants were provided the Web-based, brief psychosocial intervention, which was tailored to ICD patients and contained elements of evidence-based cognitive-behavioral protocols for PTSD. Pretest and posttest measurement assessed participants' trauma experiences, mental health, and device-specific distress (device acceptance and shock anxiety). Postintervention scores on the PTSD Checklist (PCL; M = 35.5, SD = 10.09) were significantly lower than preintervention scores (M = 46.31, SD = 9.88), t (16) = 3.51, P = 0.003, d = 1.08. Preliminary results indicate that future research with a more robust design is warranted. Given limitations in accessibility of mental health providers to manage cardiac-related psychological sequelae, brief, Web-based intervention may be an effective, supplemental, clinical modality to offer treatment to this population.

Sections du résumé

BACKGROUND
To date, treatment to reduce posttraumatic stress disorder (PTSD) symptoms in implantable cardioverter defibrillator (ICD) patients has been limited by lack of symptom recognition, lack of provider referrals, barriers to treatment access, and inadequate evidence base of treatment effectiveness in this population.
METHODS
Participants were 46 patients with ICDs (17 paired) with elevated PTSD symptoms who were recruited in electrophysiology clinics at community and university hospitals as well as ICD support forums. Participants were provided the Web-based, brief psychosocial intervention, which was tailored to ICD patients and contained elements of evidence-based cognitive-behavioral protocols for PTSD. Pretest and posttest measurement assessed participants' trauma experiences, mental health, and device-specific distress (device acceptance and shock anxiety).
RESULTS
Postintervention scores on the PTSD Checklist (PCL; M = 35.5, SD = 10.09) were significantly lower than preintervention scores (M = 46.31, SD = 9.88), t (16) = 3.51, P = 0.003, d = 1.08.
CONCLUSIONS
Preliminary results indicate that future research with a more robust design is warranted. Given limitations in accessibility of mental health providers to manage cardiac-related psychological sequelae, brief, Web-based intervention may be an effective, supplemental, clinical modality to offer treatment to this population.

Identifiants

pubmed: 30847952
doi: 10.1111/pace.13654
doi:

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

521-529

Informations de copyright

© 2019 Wiley Periodicals, Inc.

Auteurs

Jessica Ford (J)

Department of Psychology, East Carolina University, Greenville, North Carolina.

Heather Littleton (H)

Department of Psychology, East Carolina University, Greenville, North Carolina.

Lesley Lutes (L)

Department of Psychology, University of British Columbia, Kelowna, BC, Canada.

Karl Wuensch (K)

Department of Psychology, East Carolina University, Greenville, North Carolina.

Christie Benton (C)

Department of Cardiovascular Sciences, East Carolina University, East Carolina Heart Institute, Greenville, North Carolina.

John Cahill (J)

Department of Cardiovascular Sciences, East Carolina University, East Carolina Heart Institute, Greenville, North Carolina.

Christopher Hudson (C)

Carolina East Medical Center, New Bern, North Carolina.

Rajasekhar Nekkanti (R)

Department of Psychology, East Carolina University, Greenville, North Carolina.

Anil Gehi (A)

Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Samuel Sears (S)

Department of Psychology, East Carolina University, Greenville, North Carolina.
Department of Cardiovascular Sciences, East Carolina University, East Carolina Heart Institute, Greenville, North Carolina.

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