Abstract 2701: In the Home Automatic External Defibrillator Trial Psychologically Distressed Patients and Spouses Remain Distressed 2 Years After Receiving Training to Respond to Sudden Cardiac Arrest
Survival from sudden cardiac arrest (SCA) increases when patients are defibrillated within 10 minutes. Automatic external defibrillators (AEDs) are now available for home use. Little is known about the long term psychological response of patients or spouses to CPR or AED training. We hypothesized differences in the long term psychosocial outcomes between CPR and CPR/AED training in psychologically distressed post MI patients and their spouses. Participants in the Home Automatic External Defibrillator Trial (HAT) at 30 sites who were randomly assigned to CPR training (n = 219) or CPR training plus AEDs (n = 241) completed depression (BDI-II) and anxiety (STAI) scales at intake,1,12, and 24 months. The frequency of depression and anxiety were examined; those who were psychologically distressed were identified. Changes in depression and anxiety were examined with linear mixed models in psychologically distressed individuals. At study entry, 25% of the patients and 15% of the spouses were depressed and 21% of the patients and 19% of the spouses were anxious. Psychological distress, indicated by depression or anxiety of the patient (n = 128) or spouse (n = 118), occurred in 191 couples. Among psychologically distressed patients, depression and anxiety decreased over 2 years independent of group; men’s anxiety decreased more than women’s (p = .012, 95% CI:.002,.018). Among psychologically distressed spouses, depression decreased over 2 years independent of group. Changes in spouse anxiety depended on group (p = .012, 95% CI:.001,.012); anxiety decreased significantly in the CPR and remained high in the CPR/AED group. In conclusion, there were not differences in the long term depression of anxiety in psychologically distressed patients and depression in psychologically distressed spouses between CPR and CPR/AED groups. Spouses in the AED group did not experience decreases in anxiety parallel to those of the CPR group. Interventions to reduce anxiety among psychologically distressed spouses who receive AED training may be warranted. Anxiety among spouses trained to use AEDs may decrease effective implementation of this life-saving technology.