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- 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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| 3. |
- 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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- 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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| 5. |
- 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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| 6. |
- 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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- 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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