A National Needs Analysis of Sudden Cardiac Arrest Survivors

Abstract

Psychosocial outcomes of sudden cardiac arrest survivors have generally been studied in single center samples. Large, nationally representative patient surveys may offer different perspectives. The aim of the current study is to provide a needs analysis of health outcomes and psychosocial needs for this patient population. One hundred and eighty nine sudden cardiac arrest survivors (104 men, 84 women, 1 unreported) completed an online survey. A representative sample of time since cardiac arrest was achieved (28.0% within 2 years, 38.6% 2-5 years, 33.3% 5 or more years post-SCA). The self-report survey consisted of retrospective (time of cardiac event to 3 months post-cardiac event) and current ratings of health, which included quality of life, emotional health, and general health. A needs analysis for sudden cardiac arrest survivors addressing acute and long-term concerns was completed to aid in understanding appropriate educational programming for these patients. Approximately 81% of the sample had an implantable cardioverter defibrillator and 45% of patients had experienced at least one shock from their device. Patient ratings of post-sudden cardiac arrest health outcomes indicated notable change in quality of life (37.7% better, 37.2% same, 25.0% worse). Similar patterns in emotional health (33.8% better, 32.8% same, 33.3% worse) and general health (30.3% better, 46.3% same, 23.4% worse) were observed. The majority of patients reported desirable (excellent - very good - good) changes in quality of life (88.9%), emotional health (82.0%), and general health (84.1%), while others reported undesirable (fair - poor) current health ratings; quality of life (11.1%), emotional health (18%), and general health (16%). Emotional health emerged as the health functioning area most negatively impacted by sudden cardiac arrest. Needs analysis of top concerns demonstrated that the highest priority concerns were anxiety, depression, and fear of exercise across all time periods. Further analyses indicated that gender and secondary treatment type significantly impacted reported rates of anxiety, depression, and fear of exercise. To our knowledge, the current study examines patient reports from the largest sudden cardiac arrest sample in the literature. Findings highlight that immediate health outcomes post-sudden cardiac arrest are potentially adverse but many patients later report desirable quality of life, emotional health, and general health. Educational programming initiatives for sudden cardiac arrest patient issues may require shifting focus from broad health concerns to acute and long-term psychosocial needs.