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September 3, 2026Journal of Korean Academy of Fundamentals of NursingOpen Access

Higher self-care competence linked to reduced impact of uncertainty on HRQoL in ICD patients.

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Population

108 adult patients with implantable cardioverter-defibrillators receiving outpatient treatment at a tertiary…

Design

Cross-sectional

Key result

Self-care competence significantly mediated the negative impact of uncertainty on physical (indirect effect -3.26) and mental (indirect effect -4.52) health-related quality of life in patients with implantable cardioverter-defibrillators.

Authors

EJEun-Hee JoSHSoon-Jung HwangJRJeong-Lim Ryu

Discussion

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Overview

Self-care competence may buffer uncertainty effects on HRQoL in ICD patients; hypothesis-generating and requires prospective validation.

Key Points

  • To examine the mediating effect of self-care competence on the relationship between illness uncertainty and health-related quality of life in patients with implantable cardioverter-defibrillators.
  • Conducted a descriptive survey of N=108 outpatient ICD recipients at a tertiary hospital in J, Korea.
  • Assessed mediation pathways using Hayes' PROCESS macro (Model 4) with 95% bias-corrected bootstrap confidence intervals.
  • Uncertainty negatively predicted physical HRQoL (β = -9.74, p = .014), whereas self-care competence positively predicted it (β = 5.46, p = .004; model R² = 46%), with a significant indirect effect through self-care competence (-3.26, 95% bootstrap CI: -8.81 to -0.16).
  • Uncertainty negatively predicted mental HRQoL (β = -15.17, p < .001), while self-care competence positively predicted it (β = 5.80, p = .004; model R² = 39%), with a significant indirect effect through self-care competence (-4.52, 95% bootstrap CI: -10.08 to -0.14).

Study Design

Type

Cross-Sectional (n=108)

Multicenter

No

Structured PICO

P
Population
108 adult outpatients with implantable cardioverter-defibrillators, free of psychiatric disorders, were surveyed to assess the relationship between uncertainty, self-care competence, and health-related quality of life.
O
Outcome
Health-related quality of life (HRQoL), specifically physical and mental HRQoL measured by the Medical Outcomes Study Short Form-12 (MOS SF-12)patient reported

Main Result

Effect estimate: indirect effect -3.26 (95% CI -8.81 to -0.16)

Self-care competence significantly mediates the negative impact of uncertainty on both physical and mental health-related quality of life in patients with implantable cardioverter-defibrillators.

Limitations

  • Did not directly measure economic burden, limiting the interpretation of the relationship between occupational status and HRQoL
  • Cross-sectional design limits the ability to establish causal relationships
  • Single-center study limits generalizability

Cite This Study

Jo et al. (2026) conducted a cross-sectional in Implantable cardioverter-defibrillators (ICDs) (n=108). Uncertainty was evaluated on Indirect effect of uncertainty on physical HRQoL through self-care competence (indirect effect -3.26, 95% CI -8.81 to -0.16). Self-care competence significantly mediated the negative impact of uncertainty on physical (indirect effect -3.26) and mental (indirect effect -4.52) health-related quality of life in patients with implantable cardioverter-defibrillators.

synapsesocial.com/papers/6a9935e5636c6408cfa7e80chttps://doi.org/10.7739/jkafn.2026.33.3.367
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Quality of life and psychological distress in patients with implantable cardioverter-defibrillators: the PSY-ICD study2026
  2. 2The Influences of Illness Uncertainty, Health Literacy, and Self-Care on Quality of Life in Patients with Chronic Obstructive Pulmonary Disease2025
  3. 3Symptom Experiences and Coping Strategies in Turkish Patients with Implantable Cardioverter-Defibrillators: A Cross-Sectional Study Based on Interviews2025
  4. 4Patients’ Knowledge about Safe Measures Post Implantable Cardioverter Defibrillator2025
  5. 5Examining the needs of informal caregivers of patients with an implantable cardioverter defibrillator (ICD)2026