Sears Researches Psychological Care for Heart Patients
By Jeannine Manning Hutson
A nationally recognized leader in the psychological care of patients with implantable cardiac devices has joined the faculty of East Carolina University.
Dr. Sam Sears is director of health psychology and also holds an appointment to the Department of Cardiovascular Sciences at the Brody School of Medicine.
Sears and his research will be featured during a PBS medical special, “From Victim to Survivor: Journeys of Heart Failure,” scheduled to air Nov. 15.
A native of Florida, Sears worked and taught for more than 12 years at the University of Florida, where he earned his undergraduate and graduate degrees, before coming to Greenville. While there he received five teacher of the year awards from students in his department.
“This university has the potential to grow, and the East Carolina Heart Institute is a fantastic opportunity,” said Sears, who will foresee the development of the doctoral program in health psychology. “That bridge between the medical school and the university was the deal maker for me. The collaborative research opportunities are exciting.”
Sears’ research focuses on implantable cardioverter defibrillators (ICDs), which are used by cardiologists to treat annually more than 200,000 patients who have potentially life-threatening irregular heart beats. However, many of these patients have high levels of anxiety about receiving a significant shock, 750 volts, to restore a normal cardiac rhythm.
Sears researches and treats patients who become consumed with fear and worry about their devices.
“This technology is fantastic. The downside is part of the overall comprehensive care of the patient – behavioral and psychological needs. That’s the kind of care we want to provide at the East Carolina Heart Institute,” he said.
“It’s a modern-day challenge,” he said. “The progress of biotechnology produces psycho-social demands on the family. We can treat distress only after the cardiac arrest is treated.
“Cardiac patients like this are courageous. They have to go beyond their anxiety and have a little more swagger in their step. They have to live with this technology their whole life. Not been there done that, but living it every day,” Sears said.
A significant percentage of implant recipients are at risk for developing psychological problems based on their history or their experience when the devices shock their heart into normal rhythm, Sears said.
Dr. Wayne Cascio, professor of internal medicine and chief of cardiology at the Brody School of Medicine, said Sears is a perfect fit for the clinical and research work already underway at ECU.
“Since Sears’ clinical activity and research have focused on patients with cardiovascular disease, there’s a natural connection between his work and the East Carolina Heart Institute. We have immediately found a home for him in the cardiopulmonary rehabilitation and heart failure clinic at HealthSteps,” Cascio said.
“He brings expertise that allows us to develop patient- and family-focused research on how our modern technologies affect the emotional and psychological aspects of our patients,” he said.
Research Sears conducted with colleagues at the University of Florida showed that patients who reported high levels of optimism long-term showed significantly better functioning in general health, mental health, physical limitations and perception of illness than recipients with low levels of optimism.
Sears said psychological care is needed along with medical care as recipients of ICDs work to return to their day-to-day activities after surviving a heart attack.
“ICD patients and families can present with many different types of worries including, but not limited to, ICD shock, device malfunction, device recall, fears of pain or embarrassment or even fears of death. Some concerns can be addressed in a cardiology clinic, while others need to be referred for more extensive psychosocial treatment,” he said.
His most recent research on the effectiveness of an ICD shock and stress management program was published in the July 2007 edition of “Pacing and Clinical Electrophysiology.” It was the first study to examine a psychosocial intervention in shocked ICD patients using both biological and psychological markers of anxiety, he said.
At ECU, Sears will collaborate with Dr. Mariavittoria Pitzalis, professor of internal medicine and medical director of the heart failure program at Pitt County Memorial Hospital.
Her expertise is in heart failure and cardiac electrophysiology. She is internationally recognized for her work in cardiac resynchronization, a way to better organize the contraction of the heart so that it is stronger, Cascio said.
Sears’ interest in his research field began 12 years ago when he was a junior faculty member in the clinical health psychology and performed evaluations of cardiac transplant candidates.
“At that time, a sizable minority of patients began presenting with ICDs that tended to be active in terms of shock exposure. In fact, exposure to multiple shocks often triggered an acute need for consideration of all treatment options, including transplantation.
“The patients and their families were terrified of the shock experience. Their anxieties seemed somewhat reasonable for the situation but still problematic,” he said. Observations in those patients led to reviewing case studies and further investigations. “And it’s kept us busy ever since,” he said.
He has published more than 75 articles in medical literature on the psychological aspects of cardiology and co-authored with Dr. Wayne Sotile, “You Can Make a Difference: Brief Psychological Interventions for ICD Patients and Families.”