Monitoring treatment expectations in patients with an implantable cardioverter-defibrillator using the EXPECT-ICD scale

M. Habibovic, S.S. Pedersen, K.C. van den Broek, J. Denollet

Research output: Contribution to journalArticleScientificpeer-review

17 Citations (Scopus)


Patient treatment expectations may affect cardiac outcomes; however, till date, no validated instruments have been developed to monitor treatment expectations in patients with an implantable cardioverter-defibrillator (ICD). This study evaluates the predictive value of the newly developed 10-item EXPECtations Towards ICD therapy (EXPECT-ICD) in relation to anxiety, depression, and ICD related concerns 3 months post-implant.
Methods and results
Consecutive implanted ICD patients were included as part of the WEB-based distress management programme for ICD patients (WEBCARE) trial from six Dutch referral hospitals. The patients completed the baseline questionnaires briefly after ICD implantation. Information on clinical variables was captured from the patients' medical records. Patients' treatment expectations as assessed with the EXPECT-ICD questionnaire could best be represented with a two-factor model involving both negative (α = 0.84) and positive expectations (α = 0.77) with a score range of 0–20 for each factor. Negative treatment expectations were associated with higher levels of anxiety (β = 0.443; P < 0.001), depression (β = 0.506; P < 0.001), and ICD concerns (β = 0.428; P < 0.001) 3 months post-implant after controlling for demographic and clinical factors. Positive expectations were not related to any of the distress outcomes.
Negative expectations were associated with anxiety, depression, and ICD concerns 3 months post-implant. The current findings indicate that the EXPECT-ICD scale is a reliable, valid, and disease-specific measure of the treatment expectations in ICD patients. Future research needs to investigate whether addressing the patients' expectations might improve the outcome and the subjective well-being of ICD patients.Keywords: Implantable cardioverter-defibrillator, Treatment expectations, Psychological distressTopic: anxiety, patient referral, medical records, implantable defibrillators, demography, depressive disorders, internet, personal satisfaction, heart, implantable defibrillator insertion, mixed anxiety-depressive disorder, implants
Original languageEnglish
Pages (from-to)1022-1027
Issue number7
Publication statusPublished - 2014


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