Emotional Distress in Partners of Patients with an Implantable Cardioverter Defibrillator: A Systematic Review and Recommendations for Future Research

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Abstract
Both patients with an implantable cardioverter defibrillator (ICD) and their partners face challenges when adapting to the ICD. Distress is a burden on its own for partners but may also affect well being and health of patients. This review provides a systematic overview of the literature on psychological distress in partners of ICD patients and recommendations for future research. PubMed and PsycInfo were searched in March 2010 using a priori defined search terms. This search and the additional hand search resulted in 22 studies, of which 13 were quantitative and eight qualitative. Sample sizes in quantitative studies varied considerably from 10 to 196 partners, with only six of 13 studies including >50 partners. Partner levels of distress were at least on par with patient levels. The majority of large‐scale studies suggested that partner distress levels decrease in the first year postimplantation. Most studies reported no impact of ICD shocks on distress levels or quality of life in partners. ICD indication as well as comorbid conditions, age, and the psychological profile of the partner were related to distress and quality of life. Domains of concern emerging from qualitative studies were related to care of the ICD patient, helplessness and uncertainties related to shocks, role changes, sexual activities, overprotectiveness, and driving. Partner levels of distress may be as high as that of ICD patients. Research with large samples is needed to further investigate the course and determinants of partner distress and the influence that partner distress may have on patient health outcomes. (PACE 2010; 33:1442–1450)

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