adolescent, child, Delphi methodology, implantable cardioverter defibrillator, psychosocial



  1. Zeigler, Vicki L. PhD, RN
  2. Decker-Walters, Brooke BSN, RN


Background and Research Objective: Adolescents with implantable cardioverter defibrillators (ICDs) have unique psychosocial needs that are not currently addressed in the literature. To prioritize these issues into a concise cardiovascular nursing research agenda, the objective of this study was to identify current psychosocial issues in this population by obtaining expert consensus from experienced pediatric dysrhythmia clinicians.


Subjects and Methods: A 3-round electronic Delphi study was conducted. A multidisciplinary purposive sample was drawn from 2 international organizations of pediatric and young adult cardiovascular caregivers who specialize in rhythm disturbances in this patient population. Round 1 included an open-ended question in which respondents were asked to provide as many psychosocial issues as desired, but at least 5. Round 2 included the 10 most frequent issues, which participants were asked to rank (1 = most important, 10 = least important). Round 3 included the collective ranking of the respondents using mean values; respondents were asked to indicate agreement/disagreement with the final ranking. If they disagreed, they were asked to re-rank the items.


Results and Conclusions: The top 10 psychosocial issues identified by the panel included, in order of importance: fear of being shocked, sports participation/activity restrictions, feeling different from peers/peer acceptance, depression, adjustment problems, fear of death, medication noncompliance, acting out, body change/weight gain, and issues related to planning for adulthood. There was 90% agreement among the expert panel members. Ascertaining the opinions and consensus of pediatric cardiovascular dysrhythmia experts has led to the development of a concise research agenda for the psychosocial issues faced by children and adolescents with ICDs. The identification of these issues will allow nurse researchers to incorporate these findings into future studies in which interventions aimed at promoting positive adjustment to the ICD in the child and adolescent age group can be tested.