This study examined mechanisms by which social cognitive theory (SCT) interventions influence health outcomes and the importance of involving partners in recovery following the patients' receipt of an initial implantable cardioverter defibrillator (ICD). We compared direct and indirect intervention effects on patient health outcomes with data from a randomized clinical trial involving two telephone-based interventions delivered during the first 3 months post-ICD implant by experienced trained nurses: P-only conducted only with patients, and P + P conducted with patients and their intimate partners. Each intervention included the patient-focused component. P + P also included a partner-focused intervention component. ICD-specific SCT-derived mediators included self-efficacy expectations, outcome expectations, self-management behavior, and ICD knowledge. Outcomes were assessed at discharge, 3- and 12-months post ICD implant. Patients (N = 301) were primarily Caucasian, male, 64 (± 11.9) years of age with a mean ejection fraction of 34.08 (± 14.3). Intervention effects, mediated through ICD-specific self-efficacy and outcome expectations, were stronger for P + P compared to P-only for physical function (β = 0.04, p = 0.04; β = 0.02, p = 0.04, respectively) and for psychological adjustment (β = 0.06, p = 0.04; β = 0.03, p = 0.04, respectively). SCT interventions show promise for improving ICD patient physical and psychological health outcomes through self-efficacy and outcome expectations. Including partners in post-ICD interventions may potentiate positive outcomes for patients.

Trial registration number (TRN): NCT01252615 (Registration date: 12/02/2010)

本研究探讨了社会认知理论 (SCT) 干预影响健康结果的机制，以及在患者接受初始植入式心脏复律除颤器 (ICD) 后让合作伙伴参与恢复的重要性。我们将直接和间接干预对患者健康结果的影响与一项随机临床试验的数据进行了比较，该试验涉及在 ICD 植入后的前 3 个月内由经验丰富的训练有素的护士提供的两种电话干预：P-仅对患者进行，P+ P 与患者和他们的亲密伙伴。每个干预措施都包括以患者为中心的部分。P + P 还包括以合作伙伴为中心的干预部分。ICD 特异性 SCT 衍生的中介因素包括自我效能预期、结果预期、自我管理行为和 ICD 知识。在出院时、ICD 植入后 3 个月和 12 个月评估结果。患者 (N = 301) 主要是白种人，男性，64 (± 11.9) 岁，平均射血分数为 34.08 (± 14.3)。通过 ICD 特异性自我效能和结果预期介导的干预效果，对于 P + P 相比 P-only 对于身体功能（分别为 β = 0.04，p  = 0.04；β = 0.02，p  = 0.04）和心理调整 (β = 0.06, p  = 0.04; β = 0.03,p  = 0.04，分别）。SCT 干预有望通过自我效能和结果预期改善 ICD 患者的身心健康结果。在 ICD 后干预中包括合作伙伴可能会增强患者的积极结果。

试用注册号（TRN）： NCT01252615（注册日期：12/02/2010）