Identification of sleep problems, shock pain and shock anxiety of the patients with İCD implantation

Implantable Cardioverter Defibrillators (ICD) may cause patients to experience fear, stress, pain, anxiety, depression, sleep problems and sexual problems while they decrease the risk of sudden cardiac death. The aim of this study is to identify the relationship between sleep problems, shock pain and shock anxiety levels of the patients with ICD implantation and the factors affecting these problems. The population of the descriptive, cross-sectional study comprised patients who underwent ICD implantation between 2017-2020 (N=200) at the hospital where the research was conducted at. The sample of the study comprised patients who met the criteria for the research according to Gpower analysis PostHoc power analysis (n=132). Data was collected by using General Information Form, Florida Shock Anxiety Scale (FSAS), Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI) and Visual Pain Scale (VPS). Data was transferred to IBM SPSSV23 program and analysed by using t test, one way variance analysis and Kruskal Willis H test. Significance level was taken as p<0,05. Average age of the patients was 66,13, %66,7 of them were male, %56,1 of them had cardiac arrest history, %66,7 had ICD shock, %53 had sleep problems after ICD implantation and %85,2 had shock pain after ICD implantation. PSQI had a statistically significant relationship with FSAS total scores (p<0,001) and a statistically insignificant relationship with ESS (p>0,001). Age, gender, marital status, smoking, people in the household, shock caused by ICD, lying on ICD and the fear of the dislocation of ICD affected FSAS total scores; cardiac arrest history, identified sleep problems, waking up because of nightmares and to stop breathing while sleeping affected PSQI total scores; identified sleep problems, cardiac arrest history, using medication for sleep disorders, pain when lying on ICD and the pain caused by ICD shock affected ESS total scores. It was detected that ICD patients' shock anxiety levels and scores of pain during shock were above average, they had poor sleep quality, their sleepiness levels were "normal yet increased sleepiness level during the day". It can be said that shock anxiety affects sleep quality. It is suggested that attempts should be made to enhance nurses' ability to evaluate ICD patients' shock anxiety, decrease the anxiety level of patients and increase their sleep quality.