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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
Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
2004 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

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.

Place, publisher, year, edition, pages
2004. , 52 p.
Series
Linköping Studies in Health Sciences. Thesis, ISSN 1100-6013 ; 67
Series
Omvårdnadsforskning vid Hälsouniversitetet i Linköping, 13
Keyword [en]
defibrillators implantable, ICD shocks, life-threatening arrhythmia, quality of life, satisfaction, uncertainty
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-24302Local ID: 3921ISBN: 91-7373-844-1 (print)OAI: oai:DiVA.org:liu-24302DiVA: diva2:244619
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2013-09-10
List of papers
1. Life situation of patients with an implantable cardioverter defibrillator: a descriptive longitudinal study
Open this publication in new window or tab >>Life situation of patients with an implantable cardioverter defibrillator: a descriptive longitudinal study
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2001 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 10, no 4, 563-572 p.Article in journal (Refereed) Published
Abstract [en]

• 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.

Keyword
Implantable cardioverter defibrillator, patient experiences, uncertainty, information, satisfaction
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-18520 (URN)10.1046/j.1365-2702.2001.00494.x (DOI)000169890600020 ()11822504 (PubMedID)
Available from: 2009-05-29 Created: 2009-05-29 Last updated: 2017-12-13Bibliographically approved
2. Quality of life in relation to ICD shocks and uncertainty in patients living with an ICD: a 5-year old follow-up
Open this publication in new window or tab >>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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(English)Manuscript (preprint) (Other academic)
Abstract [en]

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.

Keyword
Defibrillators implantable, ICD shocks, quality of life, satisfaction, uncertainty
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-97347 (URN)
Available from: 2013-09-10 Created: 2013-09-10 Last updated: 2013-09-10

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