The goal of this project is to test a two-part nursing intervention to improve the physical the physical functioning, psychological adjustment, and health care utilization of individuals after experiencing to sudden cardiac arrest (SCA) and internal cardioverter defibrillator (ICD) implantation. SCA claims approximately 500,000 in the US per year, represent5ing 40% of the total deaths resulting from cardiovascular disease. With the advent of sophisticated emergency medical services, a greater number of persons are resuscitated and survive SCA episodes. Approximately 29% of persons survive the initial cardiac arrest, with a greater than 16,000/year. Undergoing automatic internal cardioverter defibrillator (ICD) implantation. The purpose of this study is to test the effects of a written structured informational (SI) booklet and a protocol of nursing telephone support (NTS), both of which are constructed from Bandura's Social Cognitive Theory and data from the previous study """"""""Experiences of Recovery Following Sudden Cardiac Arrest."""""""" Telephone coaching interventions by advanced practice nurses that influence patient care outcomes have not been tested previously in this population. These interventions are designed to include SCA survivors who do not live within driving distance to the medical center where their ICD was implanted, those do not have easy access to transportation, and those living in remote areas. Over a three year period the SI booklet and NTS intervention will be tested against usual care using a 2 group (N=75/group), experimental longitudinal design. Outcomes of the intervention include physical functioning, psychological adjustment, and health care utilization of SCA survivors measured at 5 times (hospital discharge, 1 month, 3 months, 6 months, and 12 months) during the first year subsequent to ICD implantation. To increase access tot those living in remove areas, the nursing intervention and all data collected are designed specifically to be delivered through the mail or on the telephone. The primary analysis for treatment effect is the change in outcome variables from baseline to 1 and 3 months. Secondarily, exploring the mediating effects specified in the theoretical model will be determined. The findings are expected to be generalizable to other populations of high risk patients who leave the hospital after a very short stay, and to whom close follow-up cre by advanced practice nurses would be advantageous.
