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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Patienters erfarenhet av information i samband med ICD-implantation (implanterbar defibrillator)

Bromander, Marie, Johansson, Susanne January 2014 (has links)
Antalet patienter med ICD-behandling (implanterbar defibrillator) ökar. Antalet patienter som behandlas med ICD beräknas vara omkring 1400-2000 patienter/år. Då behandlingen ges på indikationen risk för livshotande hjärtrytmrubbning, är kunskap om bemötande av patienten i en allvarlig livssituation och skapande av delaktighet avgörande. Patienten behöver stöd till förståelse och kunskap för att uppleva hälsa och livskvalitet. Det mellanmänskliga mötet är centralt för att ge information till patienten. Forskning finns om att leva med ICD, men få riktar in sig på information i samband med ICD-implantationen, dock menar forskare att information är viktig inför beslut av behandling och framförallt hos patienter som erbjuds behandling på primärindikation. Syftet var att belysa patienters erfarenhet av information i samband med ICD-implantation och en kvalitativ, intervjustudie, med induktiv ansats genomfördes.Erfarenheter patienterna belyste tryggheten informationen skapar där vikten av att vara förberedd inför vad som skall ske och vad som kan komma att ske är viktig. Att ha en tillgänglig och förtroendefull relation med en vårdare som har kompetens inom området var mest betydelsefullt. Att stämningen i vårdmiljön är positiv och att alla som vårdar patienten ger samstämmig information belystes som viktigt. Vårdaren bör ha ett professionellt förhållningssätt och ha kunskap kring hur man möter en människa på ett personligt plan och individualiserar informationen. Viktigt är även att informationen är väl avvägd där innehållet bör vara genomtänkt och uppriktigt. Att veta varför behandlingen behövs, vad den syftar till och hur det går till praktiskt. Väsentligt är även informationen kring risker och komplikationer, men även etiska aspekter. Närståendes medverkan var viktig för flera patienter. Viktigt är att se de belysta erfarenheterna som en helhet, då alla delar behövs för att skapa livskvalitet. Alla delar påverkar varandra och tillsammans skapas det goda resultatet. / Program: Fristående kurs
2

Caring for patients with an Implantable Cardioverter Defibrillator : Experiences of patients and healthcare professionals

Bolse, Kärstin January 2009 (has links)
Background: An Implantable Cardioverter Defibrillator (ICD) is a technical device used in the treatment of ventricular arrhythmias. After the implantation of an ICD the entire life situation can be affected with psychological and social consequences for the patient and his/her next of kin. The healthcare professionals play a vital role in providing educational information, support, and technical follow-up of the device. During recent years more and more hospitals have introduced a more team based organisation where the physicians collaborate with specialised ICD nurses. Aim: The overall aim of the thesis was to explore how patients with an ICD experienced their life situation and howhealthcare professionals described their experiences of delivering care to ICD patients. Methods: The design was descriptive, combining both quantitative and qualitative approaches, and the data was collected from Sweden and the USA. The Uncertainty of Illness Scale (MUIS-C) and Quality of life Index (QLI) instruments were used to determine the level of uncertainty and satisfaction with life (I), in-depth interviews with a phenomenographic approach was used to describe how Swedish and US patients living with an ICD conceived their life situation (II, III) and how healthcare professionals’ experienced delivering care to patients with an ICD, (IV). Finally, to explore clinical aspects of ICD care in Sweden, the Delivery of ICD Questionnaire (DOIQ) was used to describe the healthcare professionals’ experiences and a content analysis was used to describe the written educational information material provided to patients (V). Results: There were no differences in uncertainty between pre and post ICD implantation either in Swedish or the US patients. Satisfaction with life was significantly higher among US patients compared to Swedish patients both before and after ICD implantation within the health-functioning, socio-economic and psychological-spiritual domains. The Swedish ICD patients experienced a significantly higher satisfaction with life within the socioeconomic domain after 3 months. (I). The patients felt safe in having an ICD implanted, but the conceptions varied from seeing the device as a life saver to being worried about what could happen. Gratitude at having an ICD varied from happiness at being alive to something that was alien and disturbed the patient. Being more or less dependent included how patient experienced feelings from well-being to grief. Having a network varied from having sufficient support to loneliness. Having a belief in the future ranged from having confidence to look forward to resignation. Gaining awareness described patients’ adaptation to living with an ICD and limitations due to the ICD (II). The patients also underwent a transition from becoming aware of the restriction in the life situation through a process of adaption and having trust in the ICD. This phase was followed by a reorientation phase where they adapted to their life situation and the patient and his/her family regained of their lives (III). The healthcare professionals strove to provide competent and individualised care and infuse confirmation to the patients in form of information, education and support. They gave the patients tools to handle their life situation, through existential support and mediating security (IV). Half of the hospitals had nurse-based clinic and others planned to introduce them. Three hospitals performed follow-up in the form of remote home monitoring. The nurse had specific ICD education from ICD companies and/or various university courses. In the educational information material the biophysical dimensions dominated while the emotional dimension was scarcely described, and the spiritual-existential was not referred to at all (V). Conclusions: This thesis offers a further contribution to the scholarly discussion about the relationship between technology and human existence and how to cope with this transition. Our studies revealed that the embodiment of the ICD reflects a merger of experiences about its presence and potential from both patients’ and healthcare professionals’ perspective. This research hopefully encourages healthcare professionals to carefully reflect on what it is like to live with an ICD and to consider practice improvement for the patients’ and the next of kin.

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