Avoidance behaviors in patients with implantable cardioverter defibrillators.

Lemon, J; Edelman, S; Kirkness, A

Avoidance behaviors in patients with implantable cardioverter defibrillators.

Lemon, J Edelman, S Kirkness, A

Permalink

Publication Type:: Journal Article
Citation:: Heart Lung, 2004, 33 (3), pp. 176 - 182
Issue Date:: 2004-05

Closed Access

	Filename	Description	Size
	2004000076.pdf		656.9 kB	Adobe PDF	View/Open

Copyright Clearance Process

Recently Added
In Progress
Closed Access

This item is closed access and not available.

Full metadata record

Field	Value	Language
dc.contributor.author	Lemon, J	en_US
dc.contributor.author	Edelman, S	en_US
dc.contributor.author	Kirkness, A	en_US
dc.date.issued	2004-05	en_US
dc.identifier.citation	Heart Lung, 2004, 33 (3), pp. 176 - 182	en_US
dc.identifier.issn	0147-9563	en_US
dc.identifier.uri	http://hdl.handle.net/10453/4608
dc.description.abstract	BACKGROUND: Although the implantable cardioverter defibrillator (ICD) has become standard therapy for some malignant cardiac arrhythmias, the shocks delivered by the device are often experienced as aversive. Anecdotal accounts of patients avoiding specific objects or places raise the possibility that conditioned avoidance responses can be established in response to ICD shocks. OBJECTIVE: The objective of the study was to better understand the nature of avoidance behavior among ICD recipients and to examine the relevance of classical conditioning and cognitive models to ICD-related avoidance behavior. METHODS: A total of 143 recipients of ICDs completed an anonymous survey reporting on aspects of their experience with the ICD and whether they had begun avoiding specific places, objects, or activities since receiving an ICD. RESULTS: Fifty-five percent of respondents reported at least 1 category of avoidance since receiving an ICD. The frequency of reported avoidances was highest in activities (39%), followed by objects (27%) and places (17%), which were least avoided. There was no relationship between the reported experience of shocks and avoidance behavior, and little evidence for conditioned avoidance. CONCLUSION: Avoidance that is not medically recommended is common among patients with ICDs. This may have adverse effects on quality of life and perhaps the physical health of some patients. Cognitive models, rather than classical conditioning, seem to explain the majority of avoidance behavior reported in this sample. A brief educational intervention or regular participation in ICD support groups could help to dispel misinformation among patients and discourage inappropriate avoidance.	en_US
dc.language	eng	en_US
dc.relation.ispartof	Heart Lung	en_US
dc.relation.isbasedon	10.1016/j.hrtlng.2004.02.005	en_US
dc.subject.classification	Nursing	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Questionnaires	en_US
dc.subject.mesh	Defibrillators, Implantable	en_US
dc.subject.mesh	Attitude to Health	en_US
dc.subject.mesh	Health Behavior	en_US
dc.subject.mesh	Anxiety	en_US
dc.subject.mesh	Avoidance Learning	en_US
dc.subject.mesh	Behavioral Research	en_US
dc.subject.mesh	Electromagnetic Fields	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	New South Wales	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Arrhythmias, Cardiac	en_US
dc.subject.mesh	Surveys and Questionnaires	en_US
dc.title	Avoidance behaviors in patients with implantable cardioverter defibrillators.	en_US
dc.type	Journal Article
utslib.citation.volume	3	en_US
utslib.citation.volume	33	en_US
utslib.location.activity	United States	en_US
utslib.for	1102 Cardiorespiratory Medicine and Haematology	en_US
utslib.for	1110 Nursing	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Science
utslib.copyright.status	closed_access
pubs.issue	3	en_US
pubs.publication-status	Published	en_US
pubs.volume	33	en_US

Abstract:

BACKGROUND: Although the implantable cardioverter defibrillator (ICD) has become standard therapy for some malignant cardiac arrhythmias, the shocks delivered by the device are often experienced as aversive. Anecdotal accounts of patients avoiding specific objects or places raise the possibility that conditioned avoidance responses can be established in response to ICD shocks. OBJECTIVE: The objective of the study was to better understand the nature of avoidance behavior among ICD recipients and to examine the relevance of classical conditioning and cognitive models to ICD-related avoidance behavior. METHODS: A total of 143 recipients of ICDs completed an anonymous survey reporting on aspects of their experience with the ICD and whether they had begun avoiding specific places, objects, or activities since receiving an ICD. RESULTS: Fifty-five percent of respondents reported at least 1 category of avoidance since receiving an ICD. The frequency of reported avoidances was highest in activities (39%), followed by objects (27%) and places (17%), which were least avoided. There was no relationship between the reported experience of shocks and avoidance behavior, and little evidence for conditioned avoidance. CONCLUSION: Avoidance that is not medically recommended is common among patients with ICDs. This may have adverse effects on quality of life and perhaps the physical health of some patients. Cognitive models, rather than classical conditioning, seem to explain the majority of avoidance behavior reported in this sample. A brief educational intervention or regular participation in ICD support groups could help to dispel misinformation among patients and discourage inappropriate avoidance.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/4608