Negative psychological and behavioral effects associated with wearable devices in cardiovascular patients: a scoping review with implications for nursing assessment and patient education

Abstract

Wearable devices are increasingly used in cardiovascular rehabilitation, rhythm monitoring, and long-term self-management. Although clinical benefits have been widely discussed, less attention has been paid to potential negative psychological and behavioral effects. This scoping review aimed to map evidence on wearable device-related psychological and behavioral effects in cardiovascular patients and summarize implications for nursing assessment and patient education. A scoping review was conducted in accordance with the Joanna Briggs Institute methodology and the PRISMA Extension for Scoping Reviews. PubMed, Web of Science Core Collection, Cochrane Library, China National Knowledge Infrastructure, Wanfang, VIP, and SinoMed were searched for studies published from January 2014 to April 2026. Titles, abstracts, and full texts or complete available publication records were screened and charted. Records without retrievable full text or sufficient information for standardized data charting were excluded and documented. Data were synthesized using descriptive and thematic approaches. A total of 110 publications were included after revised eligibility and data-charting verification. Four categories of negative psychological and behavioral effects were identified: health anxiety and heightened symptom perception, alert-related concerns and repeated reassurance seeking, excessive self-monitoring and device dependence, and impaired self-management confidence or patient experience. Preliminary nursing assessment clues were summarized for patients using wearable devices in cardiovascular care, including fear of rehabilitation exercise, catastrophic interpretation of symptoms, device dependence with weakened adherence to medical advice, and excessive reassurance seeking. Wearable devices may support cardiovascular rehabilitation and self-management, but continuous monitoring, abnormal alerts, data inaccuracies, and insufficient interpretation may also contribute to worry, avoidance, dependence, or repeated reassurance seeking in some patients. Because direct post-PCI evidence remains limited, the nursing assessment clues proposed in this review should be interpreted as preliminary, evidence-informed prompts rather than validated screening tools.