Decisional Balance Among Potential ICD Recipients : Development Of The Implantable Cardioverter Defibrillator Decision Analysis Scale (ICD-DAS)

Abstract

Sudden cardiac death is a well-documented public health problem resulting in 400,000 deaths in the U.S. annually. The Implantable Cardioverter Defibrillator (ICD) has demonstrated benefit in reducing mortality in at risk patients. Despite the benefits of this device in treating life threatening ventricular arrhythmias, prospective patients have specific concerns about the challenges of living with an ICD. These concerns include biomedical risks, social deficits, psychological difficulties, and existential beliefs. However, there are no known measures that assess patient's perceptions of the ICD prior to implantation. In the current study, a measure regarding beliefs about the ICD was created, and then a sample of prospective ICD recipients completed the measure by rating their beliefs about the ICD. Factor analysis was performed to assess the relationship between the variables. Measures of psychopathology, quality of life, religious health fatalism, and locus of control were also completed by participants for preliminary validity estimates and to assess relationships between variables. The current study examined patient decision-making regarding the ICD and developed a 2-factor pro and con measurement approach. The ICD-DAS is comprised of 22 essential items with 2 factors labeled: ICD Pros and ICD Cons. The utility of this measure will allow for the provision of patient driven education and counseling and can be used in developing decision aid materials for prospective ICD patients.