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- Bolse, Kärstin, et al.
(författare)
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Healthcare professionals experiences of delivering care to patients with an implantable cardioverter defibrillator
- 2013
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Ingår i: European Journal of Cardiovascular Nursing. - London : Elsevier / SAGE Publications (UK and US): 12 month Embargo. - 1474-5151 .- 1873-1953. ; 12:4, s. 346-352
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Tidskriftsartikel (refereegranskat)abstract
- Background: An implantable cardioverter defibrillator (ICD) is a technical device used in the treatment of ventricular arrhythmias. After an ICD implantation, the entire life situation of the patient their next of kin can be affected psychologically and socially. Healthcare professionals play a vital role in providing educational counselling, support and technical follow-up of the device, but little is known about their experiences. less thanbrgreater than less thanbrgreater thanAim: This paper describes the experiences of Swedish healthcare professionals in delivering care to patients with an ICD. less thanbrgreater than less thanbrgreater thanMethods: A qualitative, descriptive design based on a phenomenographic approach was used. Data were collected through interviews with 12 specialist ICD nurses and 12 physicians, representing 16 ICD implantation centres in Sweden. less thanbrgreater than less thanbrgreater thanFindings: Two descriptive categories comprising seven subcategories emerged. Striving to provide competent care comprised the subcategories: providing access to care, improving ones qualifications and individualising care. Striving to infuse confirmation incorporated the subcategories: promoting independence, providing existential support, mediating security and comprising needs of next of kin. less thanbrgreater than less thanbrgreater thanConclusions: The healthcare professionals described how they wished to develop the care further. Both nurses and physicians were consistent in wanting to provide competent and confirming care based on a holistic perspective with high accessibility to the ICD team. The findings describe how healthcare professionals strive to provide professional clinical care in order to give the patients tools to handle their life situation. They suggested that more structured education and counselling according to guidelines should be provided. They also highlighted the need to increase their own competence by improving their knowledge and skills.
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| 2. |
- Brännström, Margareta, et al.
(författare)
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Sexual knowledge in patients with a myocardial infarction and their partners
- 2014
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Ingår i: Journal of Cardiovascular Nursing. - Philadelphia : Lippincott Williams & Wilkins. - 0889-4655 .- 1550-5049. ; 29:4, s. 332-339
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Sexual health and sexual activity are important elements of an individual's well-being. For couples, this topic is often affected after a myocardial infarction (MI). It has become increasingly clear that, after an MI, patients are insufficiently educated on how to resume normal sexual activity. However, sufficient data on the general knowledge that patients and partners have about sexual activity and MI are lacking.OBJECTIVE: The aims of this study were to explore and compare patients' and partners' sexual knowledge 1 month after a first MI and 1 year after the event and to compare whether the individual knowledge had changed over time. A second aim was to investigate whether patients and their partners report receiving information about sexual health and sexual activity from healthcare professionals during the first year after the event and how this information was perceived.SUBJECTS AND METHODS: This descriptive, comparative survey study enrolled participants from 13 Swedish hospitals in 2007-2009. A total of 115 patients with a first MI and their partners answered the Sex After MI Knowledge Test questionnaire 1 month after the MI and 1 year after the event. Correct responses generated a maximum score of 75.RESULTS: Only 41% of patients and 31% of partners stated that they had received information on sex and relationships at the 1 year follow-up. The patients scored 51 ± 10 on the Sex After MI Knowledge Test at inclusion into the study, compared with the 52 ± 10 score for the partners. At the 1-year follow-up, the patients' knowledge had significantly increased to a score of 55 ± 7, but the partners' knowledge did not significantly change (53 ± 10).CONCLUSIONS: First MI patients and their partners reported receiving limited information about sexual issues during the cardiac rehabilitation and had limited knowledge about sexual health and sexual activity.
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| 4. |
- Fluur, Christina, et al.
(författare)
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Patients' experiences of the implantable cardioverter defibrillator (ICD); with a focus on battery replacement and end-of-life issues
- 2013
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Ingår i: Heart & Lung. - Philadelphia, PA : Mosby. - 0147-9563 .- 1527-3288. ; 42:3, s. 202-207
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Tidskriftsartikel (refereegranskat)abstract
- Background: ICD deactivation at end-of-life is technically uncomplicated. However, it may present a psychological challenge to healthcare professionals, patients, and next-of-kin. Objective: This study explored patients' experiences of complex issues of battery replacement and deactivation of the ICD. Methods: Semistructured interviews were administered to 37 medically stable ICD-recipients. Results: The ICD-recipients lived with an uncertain illness trajectory, but the majority had not reflected on battery replacement or elective ICD deactivation. Healthcare professionals had rarely discussed these issues with patients. However, this was consistent with the ICD-recipients' wishes. Many patients had misconceptions about the lifesaving capacity of the ICD and the majority stated that they would not choose to deactivate the ICD, even if they knew they were terminally ill, and it meant they would receive multiple shocks. Conclusion: The ICD-recipients tended not to think about end-of-life issues, which imply that many patients reach the final stages of life unaware of the option of ICD deactivation. © 2013 Elsevier Inc.
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| 5. |
- Fluur, Christina, et al.
(författare)
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Spouses’ reflections on Implantable Cardioverter Defibrillator treatment with focus on the future and the end-of-life : a qualitative content analysis
- 2014
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Ingår i: Journal of Advanced Nursing. - Chichester, West Sussex : Wiley-Blackwell. - 0309-2402 .- 1365-2648. ; 70:8, s. 1758-1769
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To explore future reflections of spouses living with an implantable cardioverter defibrillator recipient with focus on the end-of-life phase in an anticipated palliative phase.Background. A history of or risk for life-threatening arrhythmias may require an implantable cardioverter defibrillator. Despite the life-saving capacity of the device, eventually life will come to an end. As discussion about preferences of shock therapy at end-of-life phase seldom takes place in advance, the implantable cardioverter defibrillator recipients may face defibrillating shocks in the final weeks of their lives, adding to stress and anxiety in patients and their families.Design. Qualitative study with in-depth interviews analysed with a content analysis.Methods. Interviews were performed with 18 spouses of medically stable implantable cardioverter defibrillator recipients during 2011–2012.Results. The spouses described how they dealt with changes in life and an uncertain future following the implantable cardioverter defibrillator implantation. Six subcategories conceptualized the spouses' concerns: Aspiring for involvement; Managing an altered relationship; Being attentive to warning signs; Worries for deterioration in the partner's health; Waiting for the defibrillating shock; and Death is veiled in silence.Conclusion. Despite the partner's serious state of health; terminal illness or death and the role of the device was seldom discussed with healthcare professionals or the implantable cardioverter defibrillator recipient. Open and honest communication was requested as important to support coping with an unpredictable life situation and to reduce worries and uncertainty about the future and end-of-life. © 2013 John Wiley & Sons Ltd.
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| 9. |
- Michaelsen, Ragnhild, et al.
(författare)
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Implementation of a research-based bachelor thesis in nursing - process and experiences
- 2014
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Ingår i: Nordisk Tidsskrift for Helseforskning. - : UiT The Arctic University of Norway. - 1504-3614 .- 1891-2982. ; 2
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Tidskriftsartikel (refereegranskat)abstract
- Implementation of a research-based bachelor thesis in nursing – process and experiencesBackground: Ability to ensure quality and to evaluate own practice of nursing, is essential in order to practice a research based health care. An increase of research skills among future nurses, are thus central. The aim of this paper is to describe experiences connected with implementation of a new research-based model for examination of bachelor thesis in bachelor degree in nursing at Molde University College, Norway.Results: The curriculum has gained a clearer focus on science and research, and informative guidelines have been developed. The final bachelor thesis is now consisting of a systematic literature review based on scientific articles. The auditorium as a learning arena in the form of a thesis defence contributes to awareness of importance of research for nursing.Conclusion: The introduction of a new research based model for the bachelor thesis has strengthened the academic environment. Currently, Bachelor of Nursing has a clear focus on research and development. Newly qualified nurses are well placed to work knowledge based and to participate in development of clinical practice.
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| 10. |
- Moser, Debra, et al.
(författare)
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Shared decision-making about end-of-life care for heart failure patients with an implantable cardioverter defibrillator: a national cohort study.
- 2014
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Ingår i: Journal of Cardiac Failure. - : Elsevier. - 1071-9164.
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Konferensbidrag (refereegranskat)abstract
- BackgroundWhether to deactivate an implantable cardioverter defibrillator (ICD) at end-of-life is an important question for patients with an ICD. Expert consensus statements recommend physicians discuss end-of-life issues with ICD patients before and after implantation and promote shared decision-making. The degree to which these recommendations are followed in patients with HF is unknown. The purpose of this study was to compare attitudes and knowledge about the ICD at end-of-life between ICD recipients with and without HF to determine how well HF patients could participate in end-of-life decisions.MethodsEvery ICD patient in Sweden is enrolled in a national registry. We mailed a survey about attitudes, knowledge and experiences (the End-of-Life-ICD Questionnaire) related to the ICD and end-of-life issues to all registry patients. Data on quality of life (Euro-QOL), anxiety and depression (Hospital Anxiety and Depression Scale) were collected to determine if these affected attitudes or knowledge.ResultsOf the 5,535 patients in the registry, 3,067 (1606 with HF; age 66±11 years; 21% women) participated. Despite patients with HF reporting worse quality of life (p<0.001), and greater depression (p<0.001) and anxiety (p<0.001) than their counterparts without HF, their attitudes and knowledge about the ICD at end-of-life were very similar. Only 39% of HF patients discussed illness trajectory with their doctor, fewer (14%)discussed deactivation with their doctor, and only 8% discussed their wishes with their family. A total of 40% of HF patients did not want to discuss deactivation with their doctor, and 64% felt that such discussions were warranted only as their prognosis worsened or they neared end-of-life (70%). Patients with HF had misconceptions about the ICD: 71% incorrectly believed the ICD always delivered shocks at the end-of-life; 27% believed ICD deactivation was the same as active euthanasia; 26% believed the ICD could only be deactivated by surgical removal; and 36% thought the ICD could be deactivated without their knowledge. With regard to deactivation of the ICD, 62% did not want it deactivated or could not make a choice even if they were dying of cancer. With regard to ICD generator replacement if needed, 54% of HF patients wanted it changed or were undecided (34%) in the context of being seriously ill with another condition; 65% wanted it changed or could not make a choice (26%) even if they were of advanced age. None of these attitudes or knowledge items differed from those of patients without HF.ConclusionICD recipients with HF hold many perceptions about the ICD at end-of-life that could interfere with effective decision-making. Without better knowledge about their ICD and its performance at the end-of-life, or without discussions with doctors and family members about these issues, HF patients with an ICD are ill-prepared to engage in shared decision-making about their ICD and its use at the end-of-life.
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