| 1. |
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| 2. |
- Bolse, Kärstin, et al.
(författare)
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Life situation related to the ICD implantation : self-reported uncertainty and satisfaction in Swedish and US samples
- 2002
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Ingår i: European Journal of Cardiovascular Nursing. - Amsterdam : Elsevier. - 1474-5151 .- 1873-1953. ; 1:4, s. 243-251
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to describe changes in the life situation related to the ICD implantation of Swedish and US samples with regard to uncertainty and satisfaction. The life situation was measured by reference to the uncertainty caused by the condition and satisfaction with the life situation. Inferential statistics were used to analyse changes within and between the Swedish and US samples. Uncertainty showed a statistically significant difference between the Swedish and US samples before as well as after the ICD implantation. A higher level of uncertainty was indicated for the US sample prior to the ICD implantation and for the Swedish sample following the implantation. In the Swedish sample, satisfaction with life showed a statistically significant difference within the socio-economic domain, indicating a higher degree of satisfaction 3 months after implantation. Satisfaction within the domains of health and functioning, socio-economics and psychological-spiritual showed a statistically significant difference between the Swedish and US samples both before and after ICD implantation, indicating a higher degree of satisfaction in the US sample. The previous study shows that the ICD-patient's life situation is changed after the implantation and that it is necessary to provide the patient with information and education based on their own preconditions. The fact that US sample was investigated at a later stage after ICD implantation than the Swedish sample may have influenced the results of the study.
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| 3. |
- Flemme, Inger, 1947-
(författare)
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Health-related quality of life in recipients with an implantable cardioverter defibrillator due to life-threatening arrhythmias : a 5 year follow-up
- 2004
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The general aim of this thesis was to describe self-reported health-related quality of life (HRQoL) in recipients with an implantable cardioverter defibrillator (ICD) due to life-threatening arrhythmias over a 5-year period. The design was prospective and longitudinal. Fifty-six patients participated in Paper I, and 35 of these patients, who had survived at least five years, were included in paper II. All patients had received their ICD as a form of secondary prevention. The Quality of Life Index-Cardiac version (QLI-C), Mishel Uncertainty in Illness Scale-Community version (MUIS-C), and multiple regression analysis were used. Higher scores indicate higher HRQoL and uncertainty. The questionnaires were completed on four occasions: before implantation, at three months and at 1 year and 5 years after implantation. ICD recipients were also asked how many shocks they had perceived. At the 5-year data collection, the average ICD recipient had lived with an ICD for 6 years and 9 months. In general HRQoL was lower at year 1 than at baseline (p = 0-033). A decrease in the socioeconomic domain was observed at year 1 (p = 0.006) but improved again at year 5 (p = 0.027) although it remained below the baseline value. ICD recipients' satisfaction with the family domain decreased from the time of the ICD implantation (p < 0.001) and from year 1 (p = 0.039) to year 5 after implantation. Uncertainty related to information had decreased at year 1 in relation to baseline (p < 0.001). A decrease in overall uncertainty was observed at year 5 in relation to year 1 (p = 0.009) as well as at year 6 in relation to baseline (p = 0.009). The longer the ICD recipient had lived with the device, the greater the risk of receiving a shock. However, ICD recipients who received shocks reported being less troubled by them over time. Uncertainty was identified as a predictor of Low HRQoL. The recipients reported a higher level of HRQoL at year 5 than at year 1. HRQoL was reasonably good 5 years after implantation, and the ICD recipients felt more secure and perceived their ICD as a lifesaver.
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| 4. |
- Flemme, Inger, et al.
(författare)
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Life situation of patients with an implantable cardioverter defibrillator : a descriptive longitudinal study
- 2001
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 10:4, s. 563-572
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Tidskriftsartikel (refereegranskat)abstract
- • The aim of this study was to describe changes in the life situation of patients with an implantable cardioverter defibrillator over a period of 1 year. A sample of 56 consecutive patients took part in the study.• Life situation was measured through uncertainty in illness, satisfaction, and fear of the life situation. Descriptive statistics were used to present results, and analytical statistics were used to map out changes over time.• Overall uncertainty showed a decrease over time. A statistically significant difference was found within the domain uncertainty related to information (P < 0.001).• Satisfaction increased within the domains health-functioning, socio-economic, psychological–spiritual, and family.• The ability to act within the domain health-functioning showed a statistical significance (P < 0.05).• The domain life changes within fear in the life situation decreased and showed a statistical significance (P < 0.05).• The overall life situation showed increased satisfaction as well as lower uncertainty and fear in the life situation.• The research indicates that patients need more information about changes in the life situation after the implantable cardioverter defibrillator-implantation. The study encourages more humanistic, holistic research about patients’ life situations as well as more education in teaching skills for health care personnel.
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| 5. |
- Flemme, Inger, 1947-, et al.
(författare)
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Living with life-saving technology : coping strategies in implantable cardioverter defibrillators recipients
- 2011
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Ingår i: Journal of Clinical Nursing. - Oxford : Blackwell Publishing. - 0962-1067 .- 1365-2702. ; 21:3-4, s. 311-321
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Tidskriftsartikel (refereegranskat)abstract
- Aims. To describe coping strategies and coping effectiveness in recipients with an implantable cardioverter defibrillator and to explore factors influencing coping.Background. Implantable cardioverter defibrillators are documented as saving lives and are used to treat ventricular tachycardia and ventricular fibrillation. Despite the implantable cardioverter defibrillator not evidently interfering with everyday life, there is conflicting evidence regarding the psychosocial impact of an implantable cardioverter defibrillator implantation such as anxiety, depression, perceived control and quality of life and how these concerns may relate to coping.Design. Cross-sectional multicentre design.Methods. Individuals (n = 147, mean age 63 years, 121 men) who had lived with an implantable cardioverter defibrillator between 6-24 months completed the Jalowiec Coping Scale-60, Hospital Anxiety and Depression Scale, Control Attitude Scale and Quality of Life Index-Cardiac version.Results. Implantable cardioverter defibrillators recipients seldom used coping strategies, and the coping strategies used were perceived as fairly helpful. Optimism was found to be the most frequently used (1·8 SD 0·68) and most effective (2·1 SD 0·48) coping strategy, and recipients perceived moderate control in life. Anxiety (β = 3·5, p ≤ 0·001) and gender (β = 12·3, p = 0·046) accounted for 26% of the variance in the total use of coping strategies, suggesting that the more symptoms of anxiety and being women the greater use of coping strategies.Conclusions. Most recipients with an implantable cardioverter defibrillator did not appraise daily concerns as stressors in need of coping and seem to have made a successful transition in getting on with their lives 6-24 months after implantation.Relevance to clinical practice. Nurses working with recipients with an implantable cardioverter defibrillator should have a supportive communication so that positive outcomes such as decreased anxiety and increased perceived control and quality of life can be obtained. Through screening for anxiety at follow-up in the outpatient clinic, these recipients perceiving mental strain in their daily life can be identified.
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| 6. |
- Flemme, Inger, 1947-, et al.
(författare)
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Living with life-saving technology : long-term follow-up of recipients with implantable cardioverter defibrillator
- 2010
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Konferensbidrag (refereegranskat)abstract
- The evidence that treatment of life-threatening arrhythmia (LTA) with an Implantable Cardioverter Defibrillator (ICD) can prolong life is convincing. Living with a lifelong heart disease will gradually influence the everyday life and encompasses some or all aspects of life. In order to influence health outcomes, the impact of the ICD must be considered in a broader context including not only the physical, but also the psychological and social functioning of the individual.The general aim of this thesis was to describe everyday life in recipients living with an ICD in a longterm perspective. The aim in Paper I was to describe changes in the life situation of recipients’ with an ICD over a period of 1 year. The aim in Paper II was to describe quality of life (QOL) and uncertainty in recipients who have an ICD and to predict QOL at long-term follow-up. Fifty-six recipients participated (I) and 35 of these recipients, who had survived at least five years, were further included (II). The Quality of Life Index-Cardiac version (I, II), Mishel Uncertainty in Illness Scale-Community version (I, II), Patient ICD Questionnaire (I) and multiple regression analysis (II) were used. Higher scores indicate higher QOL and uncertainty. The questionnaires were completed before implantation, three and twelve months after implantation (I) and also five years after implantation i.e. long-term follow up (II). At the long-term follow up, the average ICD recipient had lived with an ICD for six years and nine months (6.9 years). The results showed the overall QOL and QOL in the health/functioning domain were unchanged over time. QOL in the socio-economic (p= .002) and psychological/spiritual domains (p= .012) decreased in the first year. From baseline to long-term follow up, the QOL in the family domain (p= .011) and overall uncertainty (p= .002) decreased. Uncertainty related to the information decreased at year 1 in relation to baseline (p= .001).The aim in Paper III was to illuminate the main concern of recipients living with an ICD and how they handle this in their daily life. Sixteen recipients who had lived with an ICD between six to twenty-four months were interviewed. Data was collected and analysed in a simultaneous process according to guidelines for classical grounded theory. In the analysis, a substantive theory was generated explaining the main concern of ICD recipients and how they handle this in their daily life. The core category, labelled “Striving to resume command”, illuminates the main concern of ICD recipients. To manage this main concern, the recipients used the following strategies: Economizing resources, Distracting oneself, Submitting to one’s fate and Re-evaluating life.The aim in Paper IV was to explore relationships between OQL, coping strategies, anxiety, depression and perceived control in recipients living with an ICD and to compare those having received an ICD less or more than one year ago and those with a primary or secondary preventive indication. A cross-sectional, correlational, multicenter design was used, and 147 recipients who had lived with an ICD between six to twenty-four months completed Quality of Life Index-Cardiac version, Jalowiec Coping Scale, Hospital Anxiety and Depression Scale and Control Attitude Scale. The results showed that anxiety, depression and perceived control were predictors of QOL. Anxiety was also a predictor of coping with optimistic coping being the most used coping strategy. There was no relationship between QOL and coping. No differences were found in QOL, coping, anxiety, depression and perceived control between recipients implanted either on a primary or secondary preventive indication or having the device less or more than one year.In this thesis, it was concluded that the ICD recipients strived to resume command over their life (III) and the more control the recipients perceived the more satisfied they were with their QOL (IV) and the more symptoms of anxiety, depression and uncertainty they experienced the less satisfied they were with their QOL (II, IV). Coping strategies were used more frequently by ICD recipient perceiving more anxiety (IV). QOL was fairly good 6,9 years after implantation and ICD recipients felt less uncertain once they had passed the first year of their illness.
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| 7. |
- Flemme, Inger, 1947-, et al.
(författare)
-
Living with uncertainty : main concern for recipients of implantable cardioverter defibrillator - a qualitative study
- 2010
-
Konferensbidrag (refereegranskat)abstract
- Background:the implantable cardioverter defibrillator is a sophisticated and multifunctional device to treat life-threatening arrhythmias. With increasing numbers of recipients implanted due to rapid technical development of devices and enlarged implantation indications, the consequences for recipients with an implantable cardioverter defibrillator daily life has attracted increased attention during the last decade.Aim:to illuminate the main concern of individuals living with an implantable cardioverter defibrillator and how they handle this in their daily life.Design and method:the grounded theory method was used. Sixteen Swedish recipients (9 men) who had lived with a defibrillator for 6 to 24 months were interviewed. Data was collected and analysed in a simultaneous process according to guidelines for classic grounded theory. Results:in the analysis, a conceptual model was generated explaining the main concern of recipients with an implantable cardioverter defibrillator and how they handle this in their daily life. The core category, labelled "Living with uncertainty" illuminates the main concern of the recipients. To handle uncertainty the recipients used the following strategies: Restricting one’s activities, Distracting oneself, Accepting one’s fate and Re-evaluating one’s life.Conclusions:Recipients with an implantable cardioverter defibrillator were not paralyzed by the uncertainty they experienced. Instead, they handled the uncertainty by using different strategies which may produce a sense of perceived control to initiate a living process that facilitates physical and social activities.Relevance to clinical practice:this study suggests that nurses should support recipients with an implantable cardioverter defibrillator to handle uncertainty and contribute by optimizing the recipients sense of perceived control in daily life and thereby personal growth.
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| 8. |
- Flemme, Inger, 1947-, et al.
(författare)
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Livskvalitet och upplevda chocker under ICD-behandling : en 5-års uppföljning
- 2004
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Konferensbidrag (refereegranskat)abstract
- ICD–behandling ökar överlevnaden hos patienter (pat), som har överlevt en malign ventrikulär tachyarytmi. Pats livskvalitet (QoL) har angivits variera betydande och långtidseffekterna är ännu mindre väl kända. Vi följde ett antal konsekutiva pat under minst 5 år med avseende på livskvaliteten.Metod. Pat undersöktes med MUIS-C (Mishel Uncertainty in Illness Scale – community version) och QLI-CV (Quality of Life Index – cardiac version) och multipel regressionsanalys användes hos 35 patienter. Formulären fylldes i vid tre tillfällen: före implantationen, efter 1 och 5 år. Pats egen uppfattning om antalet upplevda chocker oavsett anledning noterades.Patienter. Ur en grupp pat, som tidigare undersöktes efter 1 år, hade 39 pat överlevt med sin ICD i minst 5 år. Av dessa avböjde tre deltagande i uppföljningen utan orsak och en pga cancer. Alla pat hade fått sin ICD på indikationen sekundär prevention. Resultat. Under det första året rapporterade 13 pat totalt 79 chocker och 22 pat ingen chock. Tio pat hade ingen chock vare sig efter 1 eller 5 år, och deras QoL var likvärdig med dem som hade haft ≤5 chocker. Tre pat rapporterade ≥6 chocker och hade sänkt QoL. Mellan år 1 och 5 rapporterade 20 pat 94 shocker och 15 pat ingen shock. Det var ingen skillnad mellan pat med eller utan chocker i deras QoL år 5 vs. år 1. Pat med chocker blev mindre besvärade med tiden.QoL var generellt sänkt år 1 vs baseline. En försämring i den socio-ekonomiska domänen sågs år 1 men var förbättrad år 5. En försämring i familjedomänen var oförändrad vid 1 och 5 år vs. baseline. En förbättring av otrygghet noterades vid 5 år vs år 1.Konklusioner. Pat med ICD mådde bättre år 5 än år 1 efter implantationen. Livskvaliteten var rimligt god 5 år efter implantationen och pat kände sig mer trygga och upplevde sin ICD som en livräddare. Pat med många chocker under det första året mådde sämre än övriga. Under resten av observationsperioden var chocktätheten lägre, möjligen delvis pga farmakologisk behandling, och pat upplevde mindre besvär av chockerna.
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| 9. |
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| 10. |
- Flemme, Inger, et al.
(författare)
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Long-term quality of life and uncertainty in patients living with an implantable cardioverter defibrillator.
- 2005
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Ingår i: Heart & lung : the journal of critical care. - St. Louis, MO : Elsevier BV. - 0147-9563 .- 1527-3288. ; 34:6, s. 386-92
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: This study describes the quality of life (QOL) and uncertainty in patients who have an implantable cardioverter defibrillator (ICD) and predicts QOL at long-term follow-up. METHODS: Long-term follow-up was defined as 6.9 years +/- 1 year (range 4.11-8.7 years). QOL was measured with the Quality of Life Index, and uncertainty was measured with the Mishel Uncertainty in Illness Scale. RESULTS: The overall QOL and health/functioning were unchanged over time. QOL in the socioeconomic (P = .002) and psychologic/spiritual domains (P = .012) decreased in the first year. From baseline to long-term follow-up, the QOL in the family domain (P = .011) and uncertainty (P = .002) decreased. Uncertainty was a predictor of low QOL. CONCLUSION: QOL was reasonably good 6.9 years post-ICD implantation. Patients felt less uncertain once they had passed the first year of their illness.
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| 11. |
- Flemme, Inger, 1947-, et al.
(författare)
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Oral Quality of Life and Coping Strategies in Recipients with an Implantable Cardioverter Defibrillator
- 2010
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Ingår i: European Journal of Cardiovascular Nursing. - Oxford : Oxford University Press. - 1474-5151 .- 1873-1953. ; 9:1, suppl.
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: To explore relationships between quality of life (QOL), coping strategies, anxiety, depression and perceived control in recipients living with an implantable cardioverter defibrillator (ICD) and compare those having received an ICD less or more than one year ago and those with a primary or secondary preventive indication.Methods: A cross-sectional, correlational design was used, and 147 individuals (mean age 63 years, 121 men) who had lived with an ICD between 6 to 24 months completed Quality of Life Index-Cardiac version, Jalowiec Coping Scale, Hospital Anxiety and Depression Scale and Control Attitude Scale.Results: Anxiety, depression and perceived control were predictors of QOL. Anxiety was also a predictor of the use of coping strategies with optimism being the most used coping strategy. No relationship was found between QOL and the use of different coping strategies. No differences were found in QOL, coping, anxiety, depression and perceived control between ICD recipients having the device less or more than one year and treated either on a primary or secondary preventive indication.Conclusions: Recipients with an ICD did not use a multitude of coping strategies, but anxiety increased the use of coping. Perceived control was the most influential predictor of QOL. Practice implications: Supportive long term follow up interventions should be tailored to the recipients that have problems adapting to the device and perceive poor control in everyday life and a decreased psychological well-being.
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| 12. |
- Flemme, Inger, et al.
(författare)
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Quality of life and coping strategies in recipients with an implantable cardioverter defibrillator
- 2009
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: To explore relationships between quality of life (QOL), coping strategies, anxiety, depression and perceived control in recipients living with an implantable cardioverter defibrillator (ICD) and compare those having received an ICD less or more than one year ago and those with a primary or secondary preventive indication. Methods: A cross-sectional, correlational design was used, and 147 individuals (mean age 63 years, 121 men) who had lived with an ICD between 6 to 24 months completed Quality of Life Index-Cardiac version, Jalowiec Coping Scale, Hospital Anxiety and Depression Scale and Control Attitude Scale. Results: Anxiety, depression and perceived control were predictors of QOL. Anxiety was also a predictor of the use of coping strategies with optimism being the most used coping strategy. No relationship was found between QOL and the use of different coping strategies. No differences were found in QOL, coping, anxiety, depression and perceived control between ICD recipients having the device less or more than one year and treated either on a primary or secondary preventive indication. Conclusions: Recipients with an ICD did not use a multitude of coping strategies, but anxiety increased the use of coping. Perceived control was the most influential predictor of QOL. Practice implications: Supportive long term follow up interventions should be tailored to the recipients that have problems adapting to the device and perceive poor control in everyday life and a decreased psychological well-being.
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| 13. |
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| 14. |
- Flemme, Inger, et al.
(författare)
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Quality of life in relation to ICD shocks and uncertainty in patients living with an ICD : a 5-year old follow-up
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Aim: To describe quality of life (QoL) in relation to ICD (implantable cardioverter defibrillator) shocks and uncertainty in patients living with an ICD and to identify QoL predictors over a 5-year period.Methods: The Mishel Uncertainty in Illness Scale and Quality of Life Index were used for 35 patients. Higher scores indicate higher uncertainty and QoL.Results: From baseline to year 1, QoL overall (p = 0.033) and in the socioeconomic domain (p = 0.006) decreased. From year 1 to 5, QoL in the socioeconomic domain increased (p = 0.027) but decreased in the family domain (p = 0.039) as did uncertainty (p = 0.009). From baseline to year 5, uncertainty (p = 0.009) and QoL in the family domain decreased (p = <0.001). Patients reporting few ICD shocks were less troubled over time, thus uncertainty is a predictor of decreased QoL.Conclusion: ICD-patients felt better at year 5 than year 1. QoL was reasonably good 5 years post-implant, and patients felt more certain and perceived the ICD as a lifesaver.
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| 15. |
- Flemme, Inger, 1947-, et al.
(författare)
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Quality of life related to shocks in ICD-recipients : a 5-year follow-up
- 2006
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Ingår i: 6th Annual Spring Meeting of the Working Group on Cardiovascular Nursing of the European Society of Cardiology and the Spring Meeting of the Norwegian National Society of Cardiovascular Nurses Bergen, Norway 5–6 May 2006. - London : Sage Publications. ; , s. S20-S20
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Konferensbidrag (refereegranskat)abstract
- Purpose: The purpose of this study was to describe QoL in relation to shocks and uncertainty in ICD-recipients and to identify predictors of QoL over a 5-year period. Methods: The design was prospective and longitudinal. Thirty-five patients who had lived with the ICD for at least five years had taken part in the study. All recipients had received their ICD as a form of secondary prevention. The questionnaires Mishel Uncertainty in Illness Scale – community version (MUIS-C), Quality of Life Index – cardiac version (QLI-CV) were completed on three occasions: before implantation, at year 1 and at year 5 after implantation. Self-reported number of shocks between the implantation and year 1 and between year 1 and year 5 were described. Data were analyzed by descriptive as well as analytical statistics. Results: In general, QoL was lower at year 1 than before implantation (p = 0.033). A decrease in the socio-economic domain was observed at year 1 (p = 0.006) but improved again at year 5 (p = 0.027) although it remained below the value before implantation. ICD recipient’s satisfaction with the family domain decreased from the time before ICD implantation (p = < 0.001) and from year 1 (p = 0.039) to year 5 after implantation. A decrease in overall uncertainty was observed at year 5 in relation to year 1 (p = 0.009). The longer the ICD recipient had lived with the device, the greater the risk of receiving a shock. However, ICD recipients who received shocks reported being less troubled by them over time. Uncertainty was identified as a predictor of low QoL. Conclusion: The recipients reported a higher level of QoL at year 5 than at year 1. QoL was reasonably good 5 years after implantation and the ICD recipient felt more secure and perceived their ICD as a lifesaver.
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| 16. |
- Flemme, Inger, et al.
(författare)
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Quality of profile 1 and 5 years after ICD implantation
- 2004
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Ingår i: European Journal of Cardiovascular Nursing. - Amsterdam : Elsevier. - 1873-1953.
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Konferensbidrag (refereegranskat)abstract
- Aim: Treatment with implantable cardioverter defibrillators (ICDs) increases survival in patients suffering from ventricular tachyarrhythmias. The physiologic effects of having an ICD implanted are well-known but there is still limited knowledge about quality of life (QoL), especially in a long-term perspective. Therefore, the aim of this prospective, follow-up study was to describe and compare uncertainty and QoL at year 1 and year 5 after implantation in patients living with an ICD.Methods: The Mishel Uncertainty in Illness Scale-community version (MUIS-C) and Quality of Life Index-cardiac version (QLI) was used for 35 patients, living with an ICD in average 6 years 9 months. Higher scores indicate higher uncertainty and QoL.Results: An improvement in uncertainty was found at year 5 compared to year 1 (p=0.009), and at year 5 compared to baseline (p = 0.009). Overall QoL decreased at year 1 compared to baseline (p = 0.033). QoL in the socioeconomic domain decreased at year 1 compared to baseline (p = 0.006), and increased at year 5 compared to year 1 (p=0.027). QoL in the family domain decreased at year 5 compared to year 1 (p=0.039), and at year 5 compared to baseline (p=<0.001).Conclusion: Patients with ICD feel better at year 5 than at year 1. The QoL is reasonable good 5 years after implant once they have passed the first years and adapted to lifestyle changes, and patients are more certain and perceive the ICD as a parachute of life.
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| 17. |
- Flemme, Inger, et al.
(författare)
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"Striving to resume command" - main concern for recipients of implantable cardioverter defibrillator
- 2009
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Earlier studies have shown that individuals with implantable cardioverter defibrillator (ICD) experience fear, stress, anxiety, and depression in their daily life, but also feelings of gratitude, safety, and belief in the future. Uncertainty and restrictions in physical, psychological and social functioning are common responses to their experiences. Aim: The aim of the study was to illuminate the main concern of individuals living with an ICD and how they handle this in their daily life. Method: Sixteen Swedish recipients (9 men) who had lived with a defibrillator for 6 to 24 months were interviewed during 2007. Data was collected and analyzed in a simultaneous process according to guidelines for classical grounded theory. Results: In the analysis, a substantive theory was generated explaining the main concern of ICD recipients and how they handle this in their daily life. The core category, labelled “Striving to resume command” illuminates the main concern of ICD recipients. To manage this main concern, the recipients used the following strategies: Economizing resources, Distracting oneself, Submitting to one’s fate and Re-evaluating life. Conclusions: Based on empirical data, a substantive theory was generated illuminating the main concern for ICD recipients and strategies they used to manage this in daily life. The theory deepens the understanding of the recipients´ striving to resume command over their lives in an ongoing adjustment process which they have to face. This knowledge has clinical relevance and suggests that nurses should support the ICD recipients in this respect and thereby contribute to optimizing their sense of control in daily life. Future research could focus on the role of family members of ICD recipients and in what way they can support rather than overprotect their closely related.
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| 18. |
- Flemme, Inger, 1947-, et al.
(författare)
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Striving to resume command of one’s life : Voices from individuals living with an ICD
- 2008
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Konferensbidrag (refereegranskat)abstract
- The aim of this study was to gain a deeper understanding for the main concern of individuals living with an implantable cardioverter defibrillator (ICD) and what they did to handle it. The study group consisted of 16 patients, who had experienced a cardiac arrest or life-threatening arrhythmias, with a mean age of 56 years. In-depth interviews, conducted 6-24 months after ICD implant, were analysed using the grounded theory method. Four emergent categories were labelled economizing resources, distracting oneself, submitting to one’s fate and revaluing life. The core category, striving to resume command of one’s life, describes the uncertain process of living with discomfort of not knowing. The participants economized with their limited resources by restricting and planning every day and distracted themselves by divert attention away from the problems at hand and engaged physically or mentally in something else. They felt omitted when they could not influence their situation and what happened to them. They had no or little control over the disease and the device and must accept physical and social changes. As time had passed, they were grateful for having survived, felt secure and accepted the ICD treatment. However, a subgroup that had experienced complications as ICD shocks had hard to accept the changed life situation.
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| 19. |
- Flemme, Inger, 1947-
(författare)
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Trygghet/säkerhet och livskvalité hos individer med ICD (implanterad hjärtdefibrillator) fem år efter implantationen
- 2007
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Ingår i: Socialmedicinsk Tidskrift. - Stockholm : Socialmedicinsk tidskrift. - 0037-833X. ; 84:3, s. 230-238
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Tidskriftsartikel (refereegranskat)abstract
- Hjärt-kärlsjukdomar (Holmberg, M, Holmberg, S coh Herlitz 1999) är den främsta orsaken till död i västvärlden. I Europa orsakas 40 % av alla dödsfall av hjärt-kärlsjukdomar. En hjärt- kärlsjukdom kan leda till livshotande rytmrubbningar (arytmier) som i sin tur kan leda till plötslig hjärtdöd. Implanterad hjärtdefibrillator (implantable cardioverter defibrillator, ICD) (Socialstyrelsen 2004) har utvecklats för att behandla livshotande arytmier. Att leva med en ICD (Luderitz et al. 1994) kan upplevas på olika sätt. En del individer lever ett normalt liv, ICD besvärar dem inte och de ser den som en livräddare. Andra förändras i sin personlighet efter implantationen (Charmaz 1987, Sauve 1995) och ICD utgör ett hinder för ett normalt liv. En individs livskvalité (Eckert och Jones 2002) påverkas inte bara av sjukdomen utan också av anpassningen till en förändrad livssituation som ett resultat av ICD. Studiernas syfte var att beskriva otrygghet/osäkerhet och livskvalité hos individer som har levt med ICD i minst fem år. Trettiofem ICD-bärare från sydvästra Sverige studerades under en 5-årsperiod med avseende på otrygghet/osäkerhet och livskvalité. Resultaten visar att otryggheten/osäkerheten var som högst ett år efter implantationen. Den totala livskvaliten och livskvaliten inom det socioekonomiska livsområdet var lägst ett år efter implantationen för att därefter åter öka fram till år fem efter implantationen. Livskvaliten inom familjelivet skattades högst från början, i förhållande till de andra livsområdena, men minskade sedan åter. Den skattades efter fem år fortfarande högt. Slutsatsen av studien är att ICD-bärare efter 5 år hade en rimligt god livskvalité med undantag från det första året. De kände sig tryggare/mindre osäkra med tiden och upplevde ICD som en livräddare
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| 20. |
- Flemme, Inger, 1947-, et al.
(författare)
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Uncertainty is a major concern for patients with implantable cardioverter defibrillators
- 2011
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Ingår i: Heart & Lung. - St. Louis : Elsevier BV. - 0147-9563 .- 1527-3288. ; 40:5, s. 420-428
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The study objective was to explore the main concern of individuals living with an implantable cardioverter defibrillator (ICD) and how they handle this in daily life. For improved management and follow-up, it is important to understand how the ICD affects the recipient's daily life. METHODS: A grounded theory method was used. Sixteen Swedish recipients (9 men) living with an ICD for 6 to 24 months were interviewed. RESULTS: The core category labeled, "Incorporating uncertainty in daily life," illuminates the main concern. To handle uncertainty, recipients used the following strategies: restricting activities, distracting oneself, accepting being an ICD recipient, and reevaluating life. CONCLUSION: Recipients were not paralyzed by uncertainty. Instead, they incorporated uncertainty in life by using strategies to handle their daily life. Questions, comments, and plans for supportive communication were provided, which can be used by healthcare professionals in cardiac rehabilitation.
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| 21. |
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| 22. |
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| 23. |
- Årestedt, Kristofer, 1968-, et al.
(författare)
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A psychometric evaluation of the four-item version of the Control Attitudes Scale for patients with cardiac disease and their partners
- 2015
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 14:4, s. 317-325
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Tidskriftsartikel (refereegranskat)abstract
- Background: The four-item Control Attitudes Scale (CAS) was developed to measure control perceived by patients with cardiac disease and their family members, but extensive psychometric evaluation has not been performed. Objective: The aim was to translate, culturally adapt and psychometrically evaluate the CAS in a Swedish sample of implantable cardioverter defibrillator (ICD) recipients, heart failure (HF) patients and their partners. Methods: A sample (n=391) of ICD recipients, HF patients and partners were used. Descriptive statistics, item-total and inter-item correlations, exploratory factor analysis, ordinal regression modelling and Cronbach's alpha were used to validate the CAS. Results: The findings from the factor analyses revealed that the CAS is a multidimensional scale including two factors, Control and Helplessness. The internal consistency was satisfactory for all scales (=0.74-0.85), except the family version total scale (=0.62). No differential item functioning was detected which implies that the CAS can be used to make invariant comparisons between groups of different age and sex. Conclusions: The psychometric properties, together with the simple and short format of the CAS, make it to a useful tool for measuring perceived control among patients with cardiac diseases and their family members. When using the CAS, subscale scores should be preferred.
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