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September 5, 2026BMC NursingOpen Access

Guideline-based nursing linked to ~54% higher device acceptance and better self-efficacy vs routine care.

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Why the study?

Does a guideline-based nursing intervention improve device acceptance and self-efficacy in patients receiving an implantable cardioverter defibrillator?

Population

60 implantable cardioverter defibrillator (ICD) candidates

Comparison

Guideline-based nursing care during the pre- and… vs Routine care (sequential control group)

Design

Cohort

Follow-up

30 days

Key result

An evidence-based nursing intervention significantly improved device acceptance (mean FPAS score 93.26 vs 60.53) and self-efficacy at 30 days post-implantation compared to routine care.

Authors

AKArnel Böke KılıçlıİAİmatullah AkyarKLKim Litwack

Discussion

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Member takes

Overview

May support nursing interventions for ICD acceptance; leaves open causal effects and durability pending RCTs.

Key Points

  • To develop an evidence-based nursing guideline and assess its effect on self-efficacy, device acceptance, and emotional adjustment among patients receiving implantable cardioverter defibrillators.
  • Conducted a quasi-experimental interventional study (NCT07449559) enrolling 60 ICD candidates between August 2021 and November 2022.
  • Allocated participants sequentially to routine care (n = 30) or a guideline-based nursing intervention developed via the ADAPTE methodology and Johns Hopkins Evidence-Based Practice Model (n = 30).
  • Evaluated psychological outcomes, device acceptance, and satisfaction across pre-implantation, discharge, Day 7, and Day 30 follow-ups.
  • Intervention recipients showed significantly higher device acceptance and ICD-related self-efficacy at both Day 7 and Day 30 compared to controls (p < 0.001).
  • Device-related distress and body image concerns were significantly lower at Days 7 and 30 (p < 0.001), while ICD outcome expectations were higher at Day 30 (p < 0.001) in the intervention arm.
  • Satisfaction with nursing care at discharge was significantly higher in the intervention group than in the routine care group (p < 0.001).

Structured PICO

Does a guideline-based nursing intervention improve device acceptance and self-efficacy in patients receiving an implantable cardioverter defibrillator?

P
Population
60 adult patients (mean age 57 years, 18% female) undergoing first-time implantable cardioverter defibrillator implantation, followed for 30 days.
I
Intervention
Guideline-based nursing care during the pre- and post-implantation periods
C
Comparator
Routine care (sequential control group)
O
Outcome
Device acceptance and ICD-related self-efficacy at Days 7 and 30patient reported

Main Result

Absolute Event Rate: 93.26% vs 60.53%

p-value: p=<0.001

A guideline-based nursing intervention significantly improves device acceptance, self-efficacy, and satisfaction while reducing distress in patients receiving an ICD.

Limitations

  • Quasi-experimental, non-randomized design with sequential cohort allocation may introduce selection and temporal bias
  • Lack of complete blinding of the outcome assessor
  • Single-center study with a predominantly male sample limits generalizability
  • Short follow-up limited to 30 days post-implantation
  • Pre-implantation baseline assessment of device acceptance and self-efficacy was not applicable

Cite This Study

Kılıçlı et al. (2026) studied First-time implantable cardioverter defibrillator (ICD) implantation (n=60). Evidence-based nursing intervention guided by a nursing guideline vs. Routine care was evaluated on Device acceptance (FPAS total score) at 30 days (p=<0.001). An evidence-based nursing intervention significantly improved device acceptance (mean FPAS score 93.26 vs 60.53) and self-efficacy at 30 days post-implantation compared to routine care.

synapsesocial.com/papers/6a9bd4346b95aff0620eb9cahttps://doi.org/10.1186/s12912-026-05335-y
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