US Patients With an Implantable Cardioverter-Defibrillator

US Patients With an Implantable Cardioverter-Defibrillator
The purpose of this paper is to describe how a selected group of United States patients with an implantable cardioverter-defibrillator perceived their life situation. A qualitative design based on the phenomenographic approach was chosen to describe the patients' conceptions of their life situation. Fourteen patients—eight men and six women, aged 21-84—were strategically selected to obtain as broad a variation as possible. The descriptive categories to emerge from the analysis of the interviews were trust, adaptability, and empowerment. The category labeled trust describes how patients trusted in the organization around them. The category labeled adaptability describes how patients adapted to living with an implantable cardioverter-defibrillator device. The category entitled empowerment describes how patients considered that they received support from family and friends as well as from health care professionals. This study suggests the need for a holistic intervention program comprising family, work, and leisure, focusing on patients' future life situation.

The implantable cardioverter-defibrillator (ICD) is a life-saving device that has become an important form of treatment and is the most effective means of controlling malignant arrhythmias. More than 300,000 persons in the United States have had this device implanted. ICD treatment will become more common in the future; therefore, it is important to know how patients perceive their life situation during the first year following the implantation. While the physiological effects of the implantation of the ICD are easily identifiable, the psychological and social consequences are more difficult to determine. Some common effects of living with an ICD are anxiety, a depressed mood, and uncertainty. Fear and anxiety are related to unpredictability and the inability to control events. A higher level of anxiety has been found especially among patients who have received multiple electric shocks. Furthermore, patients with an ICD who have received shocks perceive their device as prolonging their life, although they also experience greater anxiety due to technical problems.