The relationship between religiosity and quality of life in patients with implantable cardioverter defibrillators

Abstract

The implantable cardioverter defibrillator (ICD) is often used in treatment and prevention of lethal cardiac arrhythmias in at-risk patients. Despite its established effectiveness, ICD therapy is associated with ongoing physical, emotional, and psychosocial distress that can impact patients' quality of life (QoL). For many patients living with chronic illness, religiosity may be central to dealing with the physical and psychosocial challenges they encounter. It is hypothesized that ICD patients who are more religious will demonstrate improved QoL. To date, there are no studies that have examined the influence of religiosity on general and disease-specific QoL in the ICD population. The purpose of this study was to investigate the relationship between religiosity and QoL in ICD patients. Select variables (demographic, clinical, ICD specific, psychosocial, and religiosity) of the ICD population were explored to determine predictors of general (physical and mental health) and disease-specific QoL (patient acceptance of the device). Frankl's Motivational Theory of Meaning (1962) and Wilson and Cleary's Quality of Life Model (1995) provided the conceptual framework for this study. Using a descriptive correlational design with purposive sampling, data were collected from 101 ICD recipients who were patients at a cardiology clinic in a southeastern state. Hierarchical regression analyses were conducted to assess relationships between study variables and identify the best predictors of QoL. Study measures of religiosity did not relate to general QoL. However, there were significant correlations between religiosity and disease-specific QoL. Physical health (PH) was significantly correlated with number of comorbidities, age, and depression scores, with depression the strongest predictor of PH. Both anxiety and depression scores were identified as significant predictors of mental health (MH). Regarding disease-specific QoL, study findings indicated sixty-seven percent of the variability in patient acceptance was predicted by race, age, number of comorbidities, shock anxiety, depression, knowledge of device, and importance of religion. Overall, ICD patients in this study who were more religious reported a greater acceptance of their implantable device. Religiosity, as well as other psychosocial variables in the ICD population, could prove effective coping strategies to adjustment with this life-saving device and provide a model for interventions. Further studies are warranted to validate these findings in a larger sample.