EXAMINATION OF TREADMILL STRESS TEST EXPOSURE THERAPY FOR PEDIATRIC CARDIAC DEVICE PATIENTS (TreadExpo)
Cutitta, Katherine Elizabeth
Pediatric patients with cardiac devices report fear and anxiety associated with exertion and activity resulting in high avoidance of activities, things, or places post-device implant. Extant pediatric cardiac literature is minimal, establishing the need for improved description of the sample. The field is in need of a better understanding of the role of anxiety in physical activity and self-limiting behaviors of the pediatric arrhythmia population. Examining the strength of relationship between patient estimations for duration of exercise capacity and general anxiety, as well as cardiac specific anxiety, may provide clinicians with information to guide intervention for re-engaging this population in exertive behavior. The primary aims of the current project were: 1) to examine feasibility of using treadmill stress tests as a clinical intervention, 2) determine the effects of a treadmill test on anxiety, and 3) examine the strength of relationship between patient-predicted treadmill stress test duration and activity, psychosocial distress, and cardiac specific distress. Participants were recruited from an outpatient electrophysiology (EP) clinic at Texas Children's Hospital in Houston, Texas, presenting for a standard of care (SOC) exercise treadmill test (ETT). Child report of general anxiety and device specific anxiety was collected, as well as predicted and total ETT time for six cardiac device patients aged 12-17. Analyses included descriptives, paired t-tests, and correlations. Results indicated moderate feasibility for the current study design, after multiple logistical adjustments to the recruiting process, the protocol, and the personnel necessary to complete the procedures. The use of ETT as an anxiety intervention was not statistically efficacious in this sample. Statistical results indicated strong relationships between predicted ETT duration and general anxiety (r = 0.85, p = 0.033), post-ETT state anxiety and device acceptance (r = -0.82, p = 0.048), general anxiety and report of normal daily functioning (r = -0.84, p = 0.036), body image and Total ETT duration (r = 0.85, n = 6, p = 0.032), and post-ETT state anxiety and report of device distress (r = -0.84, p = 0.036). In conclusion, future projects could be feasible with increased research personnel, increased engagement of clinic EPs, expanded eligibility criteria, and funding to compensate families for parking or traveling expenses. Participants and families saw inherent value in researchers' improved understanding of fears of exertion via ETT. Future research should determine the impact of number of exposure sessions necessary to impact anxiety in patients who report marked anxiety or activity avoidance.
Cutitta, Katherine Elizabeth. (September 2016). EXAMINATION OF TREADMILL STRESS TEST EXPOSURE THERAPY FOR PEDIATRIC CARDIAC DEVICE PATIENTS (TreadExpo) (Doctoral Dissertation, East Carolina University). Retrieved from the Scholarship. (http://hdl.handle.net/10342/6034.)
Cutitta, Katherine Elizabeth. EXAMINATION OF TREADMILL STRESS TEST EXPOSURE THERAPY FOR PEDIATRIC CARDIAC DEVICE PATIENTS (TreadExpo). Doctoral Dissertation. East Carolina University, September 2016. The Scholarship. http://hdl.handle.net/10342/6034. December 19, 2018.
Cutitta, Katherine Elizabeth, “EXAMINATION OF TREADMILL STRESS TEST EXPOSURE THERAPY FOR PEDIATRIC CARDIAC DEVICE PATIENTS (TreadExpo)” (Doctoral Dissertation., East Carolina University, September 2016).
Cutitta, Katherine Elizabeth. EXAMINATION OF TREADMILL STRESS TEST EXPOSURE THERAPY FOR PEDIATRIC CARDIAC DEVICE PATIENTS (TreadExpo) [Doctoral Dissertation]. Greenville, NC: East Carolina University; September 2016.
East Carolina University