Document Type

Thesis - University Access Only

Award Date


Degree Name

Master of Science (MS)

Department / School

Graduate Nursing


The implantable defibrillator is the treatment of choice in patients with life threatening ventricular arrhythmias. While defibrillators reduce the incidence of death, the psychosocial impact on the patient and family can be profound. The purpose of the study was to examine the relationship between psychosocial adjustment to illness, uncertainty and coping in the implantable defibrillator population. A descriptive correlational design was used. The convenience sample consisted of 156 patients from a midwestem cardiology practice. The mean age of the population was 71.6 years. The majority of patients had a diagnosis of ischemic cardiomyopathy with a mean ejection fraction of 36.3%. The Mishel Uncertainty in Illness Scale measured uncertainty. Uncertainty score for this sample was (M = 53.3) indicating a moderate amount of uncertainty. Psychosocial adjustment was measured ·by the Psychosocial Adjustment to Illness Scale (PAIS-SR). PAIS-SR T-score for this sample was 4 7, indicating a moderate degree of maladjustment. The Jalowiec Coping Scale was used to measure coping in relation to the ICD. The coping mechanism with the highest use/effectiveness score was the optimistic coping style, followed by confrontive and self-reliant. A statistically significant positive correlation (p< .01) was found between the MUIS and the JCS optimistic use/effectiveness score. Use of optimism led to less uncertainty. Very low scores were obtained on the Jalowiec indicating less use and effectiveness of coping mechanisms overall. A significant positive correlation (p<.01) was found between uncertainty and psychosocial adjustment to illness (0.613). The study results suggest that nursing interventions need to address measures to decrease uncertainty and facilitate coping mechanisms in order to improve psychosocial adjustment in this population.

Library of Congress Subject Headings

Heart -- Diseases -- Patients -- Psychology
Implantable cardioverter-defibrillators



Number of Pages



South Dakota State University