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Long-term physical functioning and psychosocial adjustment in survivors of sudden cardiac death
1Department of Physiological Nursing, University of California, San Francisco 94143, USA.
Insights
Sudden cardiac death survivors often experience reduced physical functioning and cognitive issues, but most do not report severe psychological distress. Illness severity impacts physical health and indirectly affects mental well-being.
Area of Science:
- Cardiology
- Psychology
- Public Health
Background:
- Sudden cardiac death (SCD) survivors face unique challenges post-event.
- Understanding functional health outcomes is crucial for comprehensive survivor care.
Purpose of the Study:
- To identify and describe functional health outcomes in SCD survivors.
- To assess physical functioning, cognitive status, and psychological well-being.
Main Methods:
- Cross-sectional survey of 61 SCD survivors.
- Data collected via chart reviews, interviews, and standardized questionnaires.
- Exclusion criteria included severe comorbidities and cognitive deficits.
Main Results:
- Survivors showed significantly poorer physical functioning (p < 0.001) but maintained self-care.
- Psychological distress scores were elevated (p < 0.001), though well-being scores were normal.
- Mild to moderate cognitive impairments (memory) were reported by 25 survivors.
Conclusions:
- SCD survivors experience physical and cognitive deficits but are not typically severely psychologically distressed.
- Illness severity strongly predicts physical functioning.
- Psychological distress is indirectly linked to illness severity via physical function and work status.
Objective:
To identify and describe a range of functional health outcomes in a sample of sudden cardiac death survivors.
Design:
Cross-sectional survey.
Setting:
Northern California tertiary medical center.
Subjects:
Sixty-one sudden cardiac death survivors at least 6 months but not more than 4 years after cardiac arrest. Subjects were excluded if they had uncontrolled congestive heart failure, unstable angina, other debilitating cardiac or concomitant illness, or evident cognitive deficits.
Methods:
Chart reviews, patient interviews, and a standardized questionnaire.
Results:
Survivors reported significantly poorer physical functioning than normal subjects (p < 0.001), although none were limited in self-care. Mental Health Index Scores and subscale scores for psychologic well-being were within established norms. However, mean scores for the psychologic distress subscale were elevated (p < 0.001). Initial work return was 72%. Of the 37 (61%) survivors who were sexually active before their arrests, 78% resumed coitus. Twenty-five survivors reported mild to moderately severe impairments in memory or other cognitive skills. Poor physical functioning was associated with illness severity, change in work status, and increased anxiety. Psychologic distress was associated with change in work status and poor physical functioning, but not illness severity.
Conclusions:
Despite significant decreases in physical functioning and reports of mild to moderately severe cognitive impairments, only a minority of sudden cardiac death survivors are severely psychologically distressed. Illness severity is a strong predictor of physical functioning, but its contribution to psychologic distress is indirect, acting largely through the aegis of poor physical functioning and loss of prearrest work status.