Uncertainty as a predictor of adjustment to an implantable cardioverter defibrillator

Although the implantable cardioverter defibrillator (ICD) has reduced the risk of sudden cardiac death, some recipients experience uncertainty and adjustment problems related to the device. The study's purpose was to test hypotheses that predicted defibrillator recipients with greater uncertainty would have less psychosocial adjustment overall; less adjustment in the domestic, social, and vocational environments and in sexual relationships; and have more psychological distress at 1 and 8 weeks following hospital discharge. A repeated measures, correlational survey design was used with 94 adult defibrillator recipients from 4 hospitals. The Mishel Uncertainty in Illness Scale, Psychosocial Adjustment to Illness Scale Self-Report, and demographics were completed at both time points. The sample was predominantly white, male, and married. There were no gender differences and younger adults had more adjustment problems than older adults. Results supported all but 2 hypotheses as participants had less psychosocial adjustment overall, less adjustment in all domains except vocational environment, and more psychological distress at 1 and 8 weeks after discharge. In conclusion, ICD recipients with greater uncertainty were at greater risk for psychosocial adjustment problems during the first 2 months and may require interventions, particularly younger adults.