Date of Award

Fall 1993

Degree Type

Thesis - Restricted

Degree Name

Master of Science (MS)

Department

Nursing

First Advisor

Shaw, Christine R.

Second Advisor

Fitzgerald Miller, Judith

Third Advisor

Burke, Laura J.

Abstract

Sudden Cardiac Death is a significant health problem affecting approximately 450,000 individuals in the United States each year. At present, the most effective treatment is the Implantable Cardioverter Defibrillator {ICD), a device that continuously monitors the heart rhythm and aborts malignant dysrhythmias by means of a transcardial electrical countershock. Because of the anticipated increase in use of these devices, it is critical to study their impact on the lives of the participants. Studies completed thus far have identified problems with physical and psychological functioning. The purposes of this study were to determine the type and severity of problems encountered, the type and frequency of usage of coping strategies, and the relationship between problems encountered and coping strategies used in persons with ICDs. The sample (n=56) consisted of persons randomly chosen from an arrhythmia clinic directory associated with a large metropolitan hospital. The Chronic Illness Problem Inventory (CIPI) was used to identify problems and their severity. Minor problems were noted for the sample in the areas of sexuality, medications, body deterioration, sleeping, assertive communication, ADLs, and marital overprotectiveness. No severe problems were identified in this sample, but correlations between the subscales showed that as problems increased in one area they tended to increase in others. The Jalowiec Coping Scale (JCS) was used to determine how subjects cope with the stressor of living with an ICD. Subjects used a variety of coping strategies but overall mean use scores were low. The optimist coping style was used most frequently (mean =1.95), followed by the self-reliant, confrontive, and supportant styles. Use of the optimistic coping style was not correlated with any of the CIPI summary scales or subscales. Use of this coping style does not appear to increase as problems become more severe. The emotive, fatalistic, and evasive coping styles, although used infrequently by this sample, were positively correlated with many of the CIPI problem summary scales and subscales. Use of these strategies appears co increase as problems become more severe.

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