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Dehkordi LM, Babashahi M, Irajpour A. Nonprofessional Care in Chronic Critically Ill Patient: A Qualitative Study. Int J Prev Med 2016; 7:125. [PMID: 28028426 PMCID: PMC5159692 DOI: 10.4103/2008-7802.195209] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 10/04/2016] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Decision-making about patients with critical condition transfer from Intensive Care Unit to the general wards be delegated to their families. The aim of the study was explaining the experiences of family caregiver's about care of chronic critically ill patient. METHODS This study was conducted with a qualitative content analysis using unstructured interview. Participants were selected purposively from May 2014 to May 2015 and data collection continued until data saturation. Analysis was based on conventional content analysis. RESULTS Participants' experiences classified into three main categories as following: nonprofessional care, enhancing factors of care, and inhibiting factors of care. CONCLUSIONS Finding of the current study showed different aspects of care. Care of chronic critically ill patients is a long-term process that affected by different factors. It seems that the exploration of caregivers needs and planning supportive interventions based on their needs improve the quality of care.
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Affiliation(s)
- Leila Mardanian Dehkordi
- Department of Adult Health Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Monireh Babashahi
- Nursing and Midwifery Sciences Development Research Center, Najafabad Branch, Islamic Azad University, Najafabad, Iran
| | - Alireza Irajpour
- Nursing and Midwifery Care Research Centre, Department of Critical Care Nursing, Faculty of Nursing and Midwifery, Social Determinants of Health Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran
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Singh S, Murawski MM. Implantable Cardioverter Defibrillator Therapy and the Need for Concomitant Antiarrhythmic Drugs. J Cardiovasc Pharmacol Ther 2016; 12:175-80. [PMID: 17875944 DOI: 10.1177/1074248407305608] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Implantable cardioverter defibrillators (ICDs) are increasingly used for the prevention of sudden cardiac death in patients with life-threatening ventricular arrhythmias (VAs); however, there is a potential for severe and debilitating anxiety caused by symptoms associated with ICD therapy and anticipation of shocks. Anxiety is a psycho-logic stressor, including physiologic components that may lead to adrenergic excitation triggering new arrhythmias and ICD therapies. This often requires concomitant antiarrhythmic medication to reduce the frequency of shocks and symptomatic arrhythmias treated by anti-tachycardia pacing. Although published studies have documented the efficacy of currently available antiarrhythmics, they have limitations in patients with heart failure, may affect the defibrillation threshold, and/or have been associated with major side-effects. In conclusion, for the patient with an ICD experiencing symptomatic ventricular tachycardia (VTs) episodes or ICD shocks, there is a need for pharmacologic therapy to reduce the incidence of such events without affecting the performance of the ICD or causing major side-effects.
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Affiliation(s)
- Steven Singh
- Veterans Affairs Medical Center, Washington, DC 20422, USA.
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Pasyar N, Sharif F, Rakhshan M, Nikoo M, Navab E. Iranian Patients' Experiences of the Internal Cardioverter Defibrillator Device Shocks: a Qualitative Study. J Caring Sci 2015; 4:277-86. [PMID: 26744727 PMCID: PMC4699505 DOI: 10.15171/jcs.2015.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 06/25/2015] [Indexed: 11/09/2022] Open
Abstract
Introduction: Implantable Cardioverter Defibrillator (ICD)
is a valuable treatment for the patients at risk of sudden cardiac death. In this method,
after diagnosis of pathological cardiac rhythms, shock is automatically applied to
normalize the rhythms. Shock is discharged when the patients are conscious, but the
patients’ experiences of shock have remained unknown. Thus, this study aimed to identify
and describe the patients’ experiences of shocks received from ICD. Methods: The present qualitative study was conducted through
thematic analysis and semi-structured interviews on 9 patients mean age 41.55 (1.57) with
ICD from November 2013 to July 2014. Data analysis was also performed simultaneously using
constant comparative analysis. Results: In this study, two main themes, namely "with a
parachute for life" and "Faced with nuisance", were obtained representing the patients’
experiences regarding ICD shock. With a parachute for life included subthemes, such as
"Rebirth", "Comforter and healing", and "Life assurance". In addition, "Faced with
nuisance" consisted of 2 subthemes of "Discomfort in moments of shock" and "Displeasure
after shock". Conclusion: This study provided a basis for evaluation of
patients nursing after discharge. By identification of the patients’ experiences regarding
shock, the present study can help the professional health staff to efficiently play their
roles and provide patients with holistic care. It can also be effective in designing
behavioral and cognitive interventional programs to change the patients’ attitude and
promote their adaptation with their conditions.
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Affiliation(s)
- Nilofar Pasyar
- Department of Medical Surgical Nursing, Student Research Committee, School of Nursing and Midwifery , Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farkhondeh Sharif
- Department of Psychiatric Nursing, Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahnaz Rakhshan
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Nikoo
- Department of Cardiology, Cardiovascular Research Center, School of Medicine , Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elham Navab
- Department of Critical Care Nursing and Management, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Conelius J. A woman's experience: living with an implantable cardioverter defibrillator. Appl Nurs Res 2015; 28:192-6. [DOI: 10.1016/j.apnr.2014.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 11/01/2014] [Accepted: 11/10/2014] [Indexed: 11/17/2022]
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A comparison of implanted cardioverter/defibrillator interrogation protocol effectiveness between 2 patients in the ED. Am J Emerg Med 2014; 32:680-2. [PMID: 24746861 DOI: 10.1016/j.ajem.2014.03.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 03/13/2014] [Accepted: 03/14/2014] [Indexed: 11/23/2022] Open
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Matthews R, Cornwell J. Patient experience as a dimension of quality and nursing practice. ACTA ACUST UNITED AC 2012. [DOI: 10.12968/bjca.2012.7.9.450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Rachel Matthews
- Patient and Public Involvement, National Institute for Health Research (NIHR) Collaboration for Leadership and Applied Health Research and Care (CLAHRC) for Northwest London
| | - Jocelyn Cornwell
- The Point of Care Programme, The King's Fund and Visiting Professor, Department of Medicine, Imperial College London
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Palacios-Ceña D, Losa-Iglesias ME, Alvarez-López C, Cachón-Pérez M, Reyes RAR, Salvadores-Fuentes P, Fernández-de-Las-Peñas C. Patients, intimate partners and family experiences of implantable cardioverter defibrillators: qualitative systematic review. J Adv Nurs 2011; 67:2537-50. [PMID: 21615459 DOI: 10.1111/j.1365-2648.2011.05694.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM 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. BACKGROUND An implantable cardioverter defibrillator detects pathological cardiac rhythms and automatically converts the rhythm with electrical counter shocks. DATA SOURCES 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. REVIEW METHODS 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. FINDINGS 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. CONCLUSION 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.
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Palacios-Ceña D, Losa ME, Fernández-de-las-Peñas C, Salvadores-Fuentes P. Living with life insurance: a qualitative analysis of the experience of male implantable defibrillator recipients in Spain. J Clin Nurs 2011; 20:2003-13. [DOI: 10.1111/j.1365-2702.2010.03508.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Palacios-Ceña D, Losa-Iglesias ME, Salvadores-Fuentes P, Alonso-Blanco C, Fernández-de-las-Peñas C. Experience of elderly Spanish men with an implantable cardioverter-defibrillator. Geriatr Gerontol Int 2011; 11:320-7. [DOI: 10.1111/j.1447-0594.2010.00689.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Experiences of Driving and Driving Restrictions in Recipients With an Implantable Cardioverter Defibrillator-The Patient Perspective. J Cardiovasc Nurs 2010; 25:E1-E10. [DOI: 10.1097/jcn.0b013e3181e0f881] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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VAN DEN BROEK KRISTAC, HABIBOVIĆ MIRELA, PEDERSEN SUSANNES. Emotional Distress in Partners of Patients with an Implantable Cardioverter Defibrillator: A Systematic Review and Recommendations for Future Research. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2010; 33:1442-50. [DOI: 10.1111/j.1540-8159.2010.02885.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Palacios-Ceña D, Alonso-Blanco C, Cachón-Pérez JM, Alvarez-López C. [The daily experience of the patient with an implantable cardioverter defibrillator]. ENFERMERIA CLINICA 2010; 20:97-104. [PMID: 20199887 DOI: 10.1016/j.enfcli.2009.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2009] [Revised: 08/13/2009] [Accepted: 09/29/2009] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To describe the daily experience of patients with an automatic defibrillator (AD) implant and the adaptive changes of the patient. METHOD Qualitative and phenomenological research. Collection of data through; initially unstructured interview with half of the informants, semi-structured interviews through an open questions guide after the initial unstructured interviews and use of personal narratives of the informants. Analysis of the data using the Van Manen proposal. RESULTS We analysed the interviews of 10 participants. We collected socio-demographic variables and identified the following themes, which respond to the question "How is life with an AD": It is life "with the two sides of the coin," living in constant wait and uncertainty, accepting change, developing adaptation strategies, renegotiating relationships and sexuality and it is to live transformed. CONCLUSIONS The results of this study can be integrated into nurse clinical practice in areas such as valuation after discharge, changes in habits, control of treatment, notification of shocks, masking detection of symptoms and strategies that can jeopardise the bearer. Research needs to be developed that looks closer into the influence of other technological devices in people.
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Affiliation(s)
- Domingo Palacios-Ceña
- Departamento de Ciencias de la Salud II, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, España.
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Zayac S, Finch N. Recipients' of implanted cardioverter-defibrillators actual and perceived adaptation: a review of the literature. ACTA ACUST UNITED AC 2009; 21:549-56. [DOI: 10.1111/j.1745-7599.2009.00445.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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PEDERSEN SUSANNES, VAN DEN BERG MARTHA, ERDMAN RUUDA, VAN SON JENNY, JORDAENS LUC, THEUNS DOMINICA. Increased Anxiety in Partners of Patients with a Cardioverter-Defibrillator: The Role of Indication for ICD Therapy, Shocks, and Personality. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2009; 32:184-92. [DOI: 10.1111/j.1540-8159.2008.02201.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Many patient education guidelines for teaching heart failure patients recommend inclusion of the family; however, family-focused interventions to promote self-care in heart failure are few. This article reviews the state of the science regarding family influences on heart failure self-care and outcomes. The literature and current studies suggest that family functioning, family support, problem solving, communication, self-efficacy, and caregiver burden are important areas to target for future research. In addition, heart failure patients without family and those who live alone and are socially isolated are highly vulnerable for poor self-care and should receive focused attention. Specific research questions based on existing science and gaps that need to be filled to support clinical practice are posed.
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McLean S, Timmins F. An exploration of the information needs of spouse/partner following acute myocardial infarction using focus group methodology. Nurs Crit Care 2007; 12:141-50. [PMID: 17883646 DOI: 10.1111/j.1478-5153.2007.00215.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study aimed to explore spouse/partners' experience of the information received and required in the acute myocardial infarction (AMI) in-hospital recovery period. A dearth of information exists that uncovers the information needs of spouse/partners following AMI. Although information needs, emotional reactions, support and information provision are prevalent themes within the literature, there are few studies that specifically address these issues in this population. While survey methods abound, with more recent qualitative interviews apparent, focus group methodology is underused. The study employed a qualitative descriptive design. Using focus group techniques, 15 partners were interviewed. Emerging themes included: reactions to the event, feeling like a burden on the health service, the need for information and pulling apart - pulling together. Spouse/partners play a critical role in helping patients recover from acute cardiac events thus information and support for the latter are crucial. While spouse/partners commonly seek information as a problem-solving coping strategy, in an effort to regain personal control, spouses often lack information. This study identifies spouse/partner isolation and suggests that additional supports need to be in place to adequately deal with the challenges that AMI brings to family life. Suggested support mechanisms to enhance current provision are inclusion of spouse/partner in cardiac rehabilitation programs and hospital-based care, self-help groups supported and attended by professionals and telephone support systems.
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Affiliation(s)
- Scott McLean
- The Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh EH16 4SA, UK
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Smeulders ESTF, van Haastregt JCM, Dijkman-Domanska BK, van Hoef EFM, van Eijk JT, Kempen GIJM. Nurse- and peer-led self-management programme for patients with an implantable cardioverter defibrillator; a feasibility study. BMC Nurs 2007; 6:6. [PMID: 17880674 PMCID: PMC2096621 DOI: 10.1186/1472-6955-6-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2006] [Accepted: 09/19/2007] [Indexed: 11/16/2022] Open
Abstract
Background The prevalence of cardiovascular disease is increasing. Improved treatment options increase survival after an acute myocardial infarction or sudden cardiac arrest, although patients often have difficulty adjusting and regaining control in daily life. In particular, patients who received an implantable cardioverter defibrillator (ICD) experience physical and psychological problems. Interventions to enhance perceived control and acceptance of the device are therefore necessary. This paper describes a small-scale study to explore the feasibility and the possible benefits of a structured nurse- and peer-led self-management programme ('Chronic Disease Self-Management Program' – CDSMP) among ICD patients. Methods Ten male ICD patients (mean age = 65.5 years) participated in a group programme, consisting of six sessions, led by a team consisting of a nurse specialist and a patient with cardiovascular disease. Programme feasibility was evaluated among patients and leaders by measuring performance of the intervention according to protocol, attendance and adherence of the participating ICD patients, and patients' and leaders' opinions about the programme. In addition, before and directly after attending the intervention, programme benefits (e.g. perceived control, symptoms of anxiety and depression, and quality of life) were assessed. Results The programme was conducted largely according to protocol. Eight patients attended at least four sessions, and adherence ranged from good to very good. On average, the patients reported to have benefited very much from the programme, which they gave an overall report mark of 8.4. The leaders considered the programme feasible as well. Furthermore, improvements were identified for general self-efficacy expectancies, symptoms of anxiety, physical functioning, social functioning, role limitations due to physical problems, and pain. Conclusion This study suggests that a self-management programme led by a team consisting of a nurse specialist and a patient with cardiovascular disease seems feasible according to both patients and leaders. The programme may improve general self-efficacy expectancies, symptoms of anxiety, and quality of life (physical functioning, social functioning, role limitations due to physical problems, and pain) as well. Further investigation of the programme's effectiveness among a larger sample of ICD patients or other patient groups with cardiovascular disease, is recommended.
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Affiliation(s)
- Esther STF Smeulders
- Maastricht University, Faculty of Health, Medicine and Life sciences, School for Public Health and Primary Care, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Jolanda CM van Haastregt
- Maastricht University, Faculty of Health, Medicine and Life sciences, School for Public Health and Primary Care, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Barbara K Dijkman-Domanska
- University Hospital Maastricht, Department of Cardiology, PO Box 5800, 6202 AZ Maastricht, The Netherlands
| | - Elisabeth FM van Hoef
- Maastricht University, Faculty of Health, Medicine and Life sciences, School for Public Health and Primary Care, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Jacques ThM van Eijk
- Maastricht University, Faculty of Health, Medicine and Life sciences, School for Public Health and Primary Care, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Gertrudis IJM Kempen
- Maastricht University, Faculty of Health, Medicine and Life sciences, School for Public Health and Primary Care, PO Box 616, 6200 MD Maastricht, The Netherlands
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