Body Image Concerns in patients with an Implantable Cardioverter Defibrillator: association with other patient-reported outcome measures

AIMS: To investigate associations between body image concerns (BICs) measured by the implantable cardioverter defibrillator body image concerns questionnaire (ICD-BICQ) and other patient-reported outcomes (PROs), in a cohort of patients with an implantable cardioverter defibrillator (ICD).

METHODS AND RESULTS: In a cross-sectional survey, we included patients > 18 years implanted with a first-time ICD (VVI, DDD, and cardiac re-synchronization therapy defibrillator) who had lived with their ICD from 3-24 months. They completed the 39-item ICD-BICQ together with the Generalized Anxiety Disorder scale, Patient Health Questionnaire, Type D Scale, Health Status Questionnaire, and the Florida Patient Acceptance Survey. Data were analysed using linear regression to compare personality constructs between patients with and without BICs. Logistic repression and receiver operating characteristic curves were used to predict patients with BICs based on other PROs. A total of 330 patients completed the survey. Five patients were excluded due to re-operations leaving 325 patients in the analyses. A total of 20% reported BICs at the recommended cut-off at 36 points. Patients with BICs reported higher anxiety and depression levels, lower device acceptance and health status, and had a Type D personality as compared to patients without BICs. Florida Patient Acceptance Survey was moderately able to predict BICs, while other PROs only had limited ability to predict BICs.

CONCLUSION: Patients with BICs reported poorer PROs. The PRO instruments were not able to predict patients with BICs, indicating that the ICD-BICQ provides independent relevant clinical information. In clinical practice, healthcare professionals can use the ICD-BICQ to identify and obtain information on possible BICs. The ICD-BICQ can also be used to evaluate new operation techniques.