The effect of a mobile education program and telephone follow-up developed for patients with implantable cardioverter defibrillators on shock anxiety, device acceptance, and self-efficacy

Aim: This study was conducted to determine the effect of a mobile education program and telephone follow-up developed for patients with implantable cardioverter defibrillators (ICDs) on shock anxiety, device acceptance, and self-efficacy. Method: The study was planned as a two-phase, single-blind, randomized controlled trial. In the first phase, a mobile ICD education program (M-ICDEP) was developed; in the second phase, the effectiveness of the M-ICDEP was evaluated with 88 patients with ICDs. Data were collected through the M-ICDEP using the Personal Information Form, Florida Shock Anxiety Scale, Florida Patient Acceptance Scale, Self-Efficacy and Outcome Expectations after ICD Implantation Scales, and the Shock Management Control Form. Patients in both the intervention and control groups used the M-ICDEP for three months. The control group only had access to a brief two-page general information section of the M-ICDEP, while the intervention group had access to all sections. Telephone follow-up was conducted with patients in the intervention group at the 2nd, 5th, and 8th weeks. Data were collected twice: as a pre-test before the intervention and as a post-test in the third month. Data were analyzed with descriptive statistical analyses, the Mann-Whitney U test, the Wilcoxon signed-rank test, and correlation analysis. Results: It was observed that patients in the intervention group had lower levels of shock anxiety and higher levels of device acceptance, self-efficacy, and outcome expectations compared to the control group (p<0.001). There was a significant and strong negative relationship between shock anxiety and device acceptance (p<0.01), and between shock anxiety and self-efficacy (p<0.01); in addition, a significant and strong positive relationship was found between device acceptance and self-efficacy (p<0.01). Conclusion: The results of the study showed that the M-ICDEP and telephone follow-up developed for patients with ICDs reduced patients' levels of shock anxiety and positively influenced and increased their levels of device acceptance and self-efficacy. Keywords: Device acceptance, nursing, implantable cardioverter defibrillator, self-efficacy, shock anxiety.