Patients, intimate partners and family experiences of implantable cardioverter defibrillators: qualitative systematic review
ABSTRACT This paper is a report of an interpretive review of qualitative research on how an implantable cardioverter defibrillator affects adult recipients and their significant others.
An implantable cardioverter defibrillator detects pathological cardiac rhythms and automatically converts the rhythm with electrical counter shocks.
A systematic literature search was conducted for qualitative research papers published between January 1999 and January 2009. PubMed, Medline, ISI Web of Knowledge and CINAHL databases were searched with the following key words: internal defibrillator, implantable defibrillator and qualitative research.
Twenty-two papers were included. The critical appraisal skills programme and prompts were used to appraise studies. Thematic analysis and synthesis approaches were used to interpret evidence.
People with an implantable cardioverter defibrillator were found to experience physical, psychological and social changes. Shocks produce fear and anxiety, affecting relationships and sexual relations. The use of support groups and the use of the Internet are important in helping adjustment to an implantable cardioverter defibrillator. Women's responses to an implantable cardioverter defibrillator appear different than men's responses and include concerns about physical appearance and relationship issues. Postdischarge follow-up and educational programmes are still underdeveloped.
Patients need additional education, support and follow-up care after hospital discharge. Patients and significant others benefit from collaboration between patient associations and healthcare professional societies. Future research is needed to identify the specific challenges that women recipients face.
Full-textDOI: · Available from: Domingo Palacios-Ceña, Jul 01, 2015
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ABSTRACT: As faculty members, we frequently find that first-year doctoral students in nursing are confused about how to conduct a systematic integrated literature review. This could be due to its vague definition and a lack of recent literature that provides directions for conducting a systematic integrated literature review. This article aims to provide directions for conducting a systematic integrated literature review by identifying the essential components of published literature reviews in nursing. To achieve this goal, the literature was searched by using the keywords nursing, systematic, and review in multiple databases. A total of 267 articles were selected and are included in this systematic integrated literature review. The articles were then sorted by study design and analyzed in six areas of interests. Finally, a practical guideline for conducting systematic integrated literature reviews is proposed based on the analysis of the literature.Journal of Nursing Education 09/2012; 51(11):1-6. DOI:10.3928/01484834-20120914-02 · 0.76 Impact Factor
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ABSTRACT: IMPORTANCE Implantable cardioverter-defibrillators (ICDs) have changed the way in which patients with chronic ventricular dysfunction are evaluated and treated. OBJECTIVE To examine patient-physician communication at the time the decision is made to implant an ICD. DESIGN, SETTING, AND PARTICIPANTS Forty-one patients with ICDs and 11 cardiologists were recruited by a national marketing research company for a study comprising patient focus groups and standardized patient interviews in 3 different metropolitan areas. INTERVENTIONS Eight patient focus groups and (separately) 22 standardized patient interviews with cardiologists. MAIN OUTCOME MEASURES Patient focus group findings and the results of standardized patient interviews (each cardiologist interviewed 2 patients). RESULTS The mean (SD) patient age was 61.4 (14.7) years; 21 were female. Thirty-three patients could not recall a discussion about periprocedural or long-term complications. On a scale of 1 to 10, the mean (SD) rating of the degree to which patients felt informed before the implant procedure was 5.7 (3.2) (1 indicates "not at all informed," and 10 indicates "I had all the information I needed or wanted"). The mean (SD) estimated number of patients out of 100 who would be saved by the ICD was 87.9 (20.1). A negative perception on body image and lifestyle was prevalent. Across 22 standardized patient interviews, cardiologists frequently (in >17 of 22 of interviews) did not address or minimized or denied quality-of-life issues and long-term consequences of ICD placement, including the risk for depression, anxiety, and inappropriate delivery of shock or device advisory. In 15 of 22 of the standardized patient interviews, cardiologists used unexplained medical terms or jargon. CONCLUSIONS AND RELEVANCE Patient-physician communication about ICDs is characterized by unclear representation and omission of information to patients, with notable lack of attention to psychological and long-term risks. Training of cardiologists on information exchange with patients may promote informed decision making and preempt threats to patient quality of life.JAMA Internal Medicine 02/2013; 173(7):1-7. DOI:10.1001/jamainternmed.2013.3171 · 13.25 Impact Factor
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ABSTRACT: Aims and objectivesTo determine the experiences, problems and the need for care and education of implantable cardioverter defibrillator-implanted patients and to assess the effects of an education and nurse follow-up programme on their quality of life, anxiety, depression and knowledge level. Background Although implantable cardioverter defibrillator has become a well-established therapy for people experiencing potentially lethal dysrhythmias, implantable cardioverter defibrillator patients may have physical and psychosocial problems due to the implantation. Applying a planning education and follow-up programme to implantable cardioverter defibrillator-implanted patients may prevent the need for more intensive treatment during the postimplantation period. DesignA mixed methods design that used both qualitative and quantitative data collections and analysis was used for this study. Methods The study was performed in the cardiology department in Turkey between 2009-2010. The data were collected using the Semi-Structured Interview Form', Form for Assessment of Patients' Knowledge Level about implantable cardioverter defibrillator', Spielberger's State-Trait Anxiety Inventory', Beck Depression Inventory II' and The Short-Form 36 Health Survey'. All forms were completed at the beginning of the study and at sixmonths. The study included 27 patients in the experimental group and 27 patients in the control group. ResultsThe results showed that the patients were living with various physical and psychosocial problems and insufficient knowledge regarding the implantable cardioverter defibrillator. Education and follow-up programme increased knowledge levels, decreased anxiety and depression scores and improved several subscales of quality of life in the experimental group patients. Conclusion It was recommended that education and follow-up programme be used for patients scheduled to undergo implantable cardioverter defibrillator implantation, starting before implantation and continuing thereafter, to help patients adapt to a life with implantable cardioverter defibrillator. Relevance to clinical practicePlanned education and follow-up programme conducted by nurses may improve the knowledge levels and quality of life, anxiety and depression scores of the implantable cardioverter defibrillator-implanted patients.Journal of Clinical Nursing 04/2013; 22(17-18). DOI:10.1111/jocn.12201 · 1.23 Impact Factor