An exploratory study to determine if younger patients’ with implantable cardioverter defibrillators have an improved quality of life following cardiac rehabilitation
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AbstractThe quality of life and anxieties of young patients with implantable cardioverter defibrillators (ICD) are not clearly understood. A small number of studies have looked at both physical and psychological issues in this group however not by evaluating attendance and outcomes of ICD patients’ participating in cardiac rehabilitation (CR). The study aims to establish whether a CR programme offered to young ICD patients (less than 50 years of age) helps improve their quality of life and reduces stress and anxiety levels. A comparison was made to a group of young ICD patients who had not yet completed a CR programme. The sample size was twenty ICD patients with inherited cardiac conditions who had an ICD implanted in the last eighteen months. Ages ranged from 23-49 years, mean age was 40 (± 7.83). The CR group (n=10) had enrolled on an eight week CR programme at Imperial College Healthcare NHS Trust and completed a quality of life questionnaire and Hospital Anxiety and Depression Scale (HADS) at baseline and after the programme. The non-CR group (n=10) were asked to complete the same questionnaires. Retrospective questionnaire data was analysed pre and post CR using repeated measures and compared with prospective data collected from the non-CR group. Quality of life components included physical fitness, feelings, daily activities, social activities, pain, change in health, overall health, social support and quality of life. In total five patients in the CR group completed the CR programme within the study timeframe and 80% of patients in the non-CR group returned the questionnaires. None of the CR group quality of life scores were found to be statistically significant following CR. There was a reduction between pre and post questionnaire median scores in components ‘quality of life’ (12.5%), ‘daily activities’ (25%), and ‘physical fitness’ (25%). A reduction of 14.29% was observed in the CR group depression scores, however differences in both anxiety and depression scores were not found to be significant (p=0.680, p=0.06 respectively). Post CR scores and non-CR group quality of life scores were not significantly different. This exploratory study identified areas of quality of life where younger ICD patients experience problems and how CR may assist them in their initial recovery after ICD implant. A reduction was found in depression scores following CR, however it is not clear whether CR improves quality of life for this population. There may be scope for specific ICD follow up in the future as these patients currently have access to specialist advice from healthcare professionals within Cardiology.
PublisherUniversity of Chester
TypeThesis or dissertation
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