Changes in Anxiety and Self-Care Practices in Heart Failure Patients after Wireless Implantable Hemodynamic Monitor Implants

Abstract

Background: Heart Failure (HF) is a chronic cardiac disease that places a significant burden on patients through reduced functioning, unpleasant symptoms, and extensive disease management routines. Wireless implantable hemodynamic monitors (W-IHMs) are a novel technology that assists healthcare providers in tailoring medication regimens to slow disease progression and reduce symptom expression. Initial research indicates that this device improves patient outcomes, but no mechanism has yet been determined. The purpose of this study was to determine if changes in patient experiences of anxiety and their self-care routines after receiving these devices may provide information about mechanisms involved in improved patient outcomes. Methods: Nineteen HF patients who received an W-IHM implant completed a packet of surveys pre-implant and at one-month post-implant including the Cardiac Anxiety Questionnaire (CAQ) and Self Care of Heart Failure Index version 6.2 (SCHFI v6.2), as well as an initial demographic questionnaire. These data were used to examine changes in patient heart-focused anxiety and disease management routines after receiving a W-IHMs device. Results: Results indicated that patients do experience a significant reduction in heart focused anxiety, and particularly a reduction in fear related to their HF. Patients also reported an increase in self-care behaviors. However, the reduction in heart focused anxiety was not significantly related to the increase in self-care behavior, and changes in both anxiety and self-care behaviors were not related to any demographic variables. Discussion: Patients with HF who receive a W-IHM device experience a reduction in heart focused anxiety, as well as an increase in self-care behaviors related to HF disease management. It is possible that the increase in self-care behaviors is partially responsible for the improved outcomes for HF patients receiving a W-IHM device, but this data indicated that the increase in self-care behaviors may not be a result of reduced heart-focused anxiety. Implications for further research are discussed.