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Are ICD recipients ...
Are ICD recipients able to foresee if they want to withdraw therapy or deactivate defibrillator shocks?
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- Thylén, Ingela (författare)
- Östergötlands Läns Landsting,Linköpings universitet,Avdelningen för omvårdnad,Hälsouniversitetet,Kardiologiska kliniken US
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- Moser, Debra (författare)
- College of Nursing, University of Kentucky, Lexington, USA
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- Chung, Misook (författare)
- College of Nursing, University of Kentucky, Lexington, USA
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- Miller, Jennifer (författare)
- College of Nursing, University of Kentucky, Lexington, USA
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- Fluur, Christina (författare)
- Östergötlands Läns Landsting,Kardiologiska kliniken US
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- Strömberg, Anna (författare)
- Östergötlands Läns Landsting,Linköpings universitet,Avdelningen för omvårdnad,Hälsouniversitetet,Kardiologiska kliniken US
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(creator_code:org_t)
- Elsevier, 2013
- 2013
- Engelska.
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Ingår i: IJC Heart & Vessles. - : Elsevier. - 2214-7632. ; 1, s. 22-31
- Relaterad länk:
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- BackgroundExpert consensus statements on management of implantable cardioverter defibrillators (ICDs) emphasize the importance of having discussions about deactivation before and after implantation. These statements were developed with limited patient input. The purpose of this study was to identify the factors associated with patients' experiences of end-of-life discussions, attitudes towards such discussions, and attitudes towards withdrawal of therapy (i.e., generator replacement and deactivation) at end-of-life, in a large national cohort of ICD-recipients.MethodsWe enrolled 3067 ICD-patients, administrating the End-of-Life-ICD-Questionnaire.ResultsMost (86%) had not discussed ICD-deactivation with their physician. Most (69%) thought discussions were best at end-of-life, but 40% stated that they never wanted the physician to initiate a discussion. Those unwilling to discuss deactivation were younger, had experienced battery replacement, had a longer time since implantation, and had better quality-of-life. Those with psychological morbidity were more likely to desire a discussion about deactivation. Many patients (39%) were unable to foresee what to decide about deactivation in an anticipated terminal condition. Women, those without depression, and those with worse ICD-related experiences were more indecisive about withdrawal of therapy. Irrespective of shock experiences, those who could take a stand regarding deactivation chose to keep shock therapies active in many cases (39%).ConclusionsDespite consensus statements recommending discussions about ICD-deactivation at the end-of-life, such discussion usually do not occur. There is substantial ambivalence and indecisiveness on the part of most ICD-patients in this nationwide survey about having these discussions and about expressing desires about deactivation in an anticipated end-of-life situation.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
Nyckelord
- Arrhythmias
- Attitudes
- End-of-life
- Experiences
- Implantable cardioverter defibrillator
- Patient preferences
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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