Psychological distress across the course of care: a case study from implantable cardioverter defibrillator to cardiac transplantation evaluation.

The psychological distress of cardiac patients can complicate treatment or the recovery process. This case study presents a 47-year-old male recipient of an implantable cardioverter defibrillator who experienced multiple, consecutive shocks and subsequently developed anxiety and depressive difficulties. Psychological treatment to diminish these symptoms was employed. Despite declining cardiac function, the patient made significant progress in managing this negative affect. Subsequently, he was evaluated for cardiac transplant, and this treatment progress became critical evidence of his psychosocial suitability for transplant.

Supportive communication with implantable cardioverter defibrillator patients: seven principles to facilitate psychosocial adjustment.

METHODS: This article incorporates known findings from the psychological literature regarding health behaviors and adjustment to cardiac illness with identified psychosocial needs of implantable cardioverter defibrillator (ICD) patients. An emphasis is placed on healthcare providers' unique ability to facilitate adjustment during routine patient contacts. RESULTS: Seven principles of supportive communication are presented to enhance healthcare providers' awareness of the psychosocial needs of ICD patients. A table of "quotes" representing each principle is provided to show how each form of supportive communication may be delivered to optimize health outcomes for ICD patients. CONCLUSIONS: Brief, routine communication between healthcare providers and ICD patients about psychosocial issues can facilitate patient adjustment. Although not sufficient to meet the needs of all ICD patients, supportive communication bolsters problem-solving and coping strategies of most ICD patients. For patients with more severe psychological adjustment difficulties, supportive communication may lead to better identification of patients who would benefit from referrals to mental health professionals.