München, Techn. Univ., Diss., 2004.

I Sverige drabbas cirka 5000 personer av plötsligt hjärtstopp utanför sjukhus varje år. Tiden är en viktig faktor för patientens överlevnad och irreversibla skador på kroppen sker redan efter cirka 5 minuter. Chansen att överleva ett plötsligt hjärtstopp är helt beroende av tidigt utförd hjärt-lungräddning (HLR) samt tidig behandling med en hjärtstartare. Ambulansens framkörningstid har ökat de senaste åren. Tidigare studie visar tidsvinsterna med att en hjärtstartare skickas med drönare i väntan på att ambulans anländer. Det finns dock inga studier som undersöker närståendes upplevelser och hur de interagerar med en drönare som kommer med en hjärtstartare. För att få kunskap om vilket emotionellt och praktiskt stöd de närstående behöver och hur bästa möjliga handlingsberedskap kan skapas vid dessa hjärtstoppssituationer bör en sådan studie utföras. Syftet med studien var att beskriva och förstå närståendes upplevelser och handlingsförmåga i en prehospital HLR-situation där hjärtstartare levereras med en drönare, samt hur situationen påverkas av att vara en eller två närstående på plats. Den metod som användes var ett kvasiexperiment med två jämförande grupper. Åtta studiedeltagare genomförde två olika typer av simuleringar där de hittade sin anhöriga medvetslös på golvet i hemmet. 112 larmades och en hjärtstartare levererades med drönare. Simuleringarna filmades och deltagarnas intervjuades. Resultatet redovisas med hjälp av tre generiska kategorier: Teknik och handlingsberedskap; Stöd från samtalet med larmoperatören samt Hjälpen och beslutsfattande. De mest framträdande slutsatserna av resultatet var att stress har en negativ inverkan på följsamheten samt att ”hands-off” tiden (den tiden ingen närstående befinner sig bredvid patienten och kan utföra kompressioner) skiljer sig markant om det är en eller två närstående på plats.

Orientador: Sérgio Santos Muhlen / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Elétrica e de Computação / Made available in DSpace on 2018-08-17T09:39:56Z (GMT). No. of bitstreams: 1 Batista_DeboraDiasLeister_M.pdf: 4578908 bytes, checksum: d50788bb749f44349ed7c6d97a0151eb (MD5) Previous issue date: 2010 / Resumo: Este trabalho apresenta a construção e a aplicação de um sistema hipermídia para facilitar o ensino técnico de equipamentos médico-hospitalares, num curso técnico mantido pela industria, buscando contribuir para o processo de ensino e aprendizagem. Nesta primeira versão o sistema hipermídia esta focado em um equipamento medico (desfibrilador cardíaco). A avaliação foi realizada em duas etapas. Na primeira foi selecionado um grupo de alunos que realizaram um pré-teste para determinar seus conhecimentos prévios sobre os princípios de funcionamento do desfibrilador cardíaco, suas partes e componentes; em seguida utilizaram o sistema proposto, e finalmente um pós-teste para avaliar o ganho no aprendizado. Na segunda etapa a hipermídia foi disponibilizada para os alunos e docentes que tivessem interesse, e após algumas semanas de utilização livre responderam um questionário de opinião sobre o sistema. Os resultados mostraram que o nível de aprendizagem foi significativamente melhor entre os estudantes que utilizaram o sistema hipermídia, e as opiniões da pesquisa também foram bastante favoráveis a utilização da hipermídia como apoio ao ensino, confirmando a sua validade para o processo de ensino e aprendizagem / Abstract: This study presents the construction and application of a hypermedia system aiming to facilitate technical training of medical-hospital equipment technicians, in a technician preparation course supported by an industrial institution. In this first version, the hypermedia system is focused on a single equipment (cardiac defibrillator). The system was evaluated in two steps: in the first a selected group of students, having passed a pre-test to determine their previous knowledge on the principles, parts and components of cardiac defibrillator, have used the system proposed, and then they were submitted to a post-test to evaluate the learning. In the second step the hypermedia was offered for students and teachers interested on it, and after some weeks of free use they participated on a survey with questions about the system. The results showed a learning level significantly greater among students that used the hypermedia system, and the opinions on the survey were also very favorable to the use of this tool as a teaching support, confirming its value on the teaching-learning process / Mestrado / Engenharia Biomedica / Mestre em Engenharia Elétrica

Background: The implantable cardioverter defibrillator (ICD) is the most effective treatment available for terminating potentially life-threatening ventricular tachycardia and ventricular fibrillation and reducing the risk of mortality. Despite its established health benefits, ICD therapy is accompanied by a unique array of patient and psychological factors meriting ample research attention. The purpose of this paper is to examine research trends and results regarding patient factors in cardiac and ICD research and to discuss key areas for future research. Hypothesis: An increase in articles associated with patient factors in cardiac and ICD research will be shown over time. Methods: The Medical Subject Heading (MeSH) system in PubMed was used to index articles under a range of psychosocial headings for both cardiovascular disease and ICDs to quantify the frequency of articles published across time, the journals most frequently utilized, the most productive institutions, and the most common areas of inquiry. Results: A significant positive relationship was revealed between patient factors in cardiac research (r = 0.96, p < 0.01) and ICD research (r = 0.88, p < 0.01) over time. Research is limited by the small number of investigations and institutions. Of the 178 articles on patient factors in ICD research, the most frequent areas of inquiry were psychosocial treatment (70.79%), anxiety (33.15%), quality of life (32.02%), and depression (29.78%). Conclusion: Future research examining positive adjustment is warranted, especially in light of increased prophylactic ICD implantation and possible decreased treatment burden associated with decreased shocks.

Bakgrund: Hjärt-kärlsjukdomar är den vanligaste dödsorsaken globalt. Antalet hjärtstopp och personer som lever med en implanterbar defibrillator (ICD) har ökat. Behandling med en ICD är standard i vården för att primärt och sekundärt förebygga en plötslig hjärtdöd. Syfte: Att beskriva personers upplevelser av att leva med en ICD. Metod: En litteraturstudie med kvalitativ design baserad på 12 vetenskapliga artiklar som analyserats genom kvalitativ innehållsanalys med manifest ansats. Resultat: Resultatet av litteraturstudien presenteras i fem kategorier; Att leva med olika typer av rädslor, Att leva med förändringar och begränsningar, Att information och stöd var viktigt, Att anpassa sig till och acceptera ICD:n, Att få en andra chans i livet. Slutsats: Personer som lever med ICD upplever olika känslor som rädslor och sorg, till tacksamhet och trygghet. ICD:n leder till olika förändringar och begränsningar i livet som personerna behöver acceptera och anpassa sig till. Personerna upplever att information och stöd kan underlätta processen. Vidare forskning behövs för att öka sjuksköterskors kunskaper om personernas behov.

No description available.

Background: Implantable cardioverter defibrillators (ICDs) deliver therapy in the form of an internal shock should a life-threatening arrhythmia occur. Literature suggests that patients have misconceptions regarding ICD therapy and unmet information needs. Purpose: This study assessed the feasibility of delivering a pre-implantation nurse-led educational intervention to ICD candidates. Methods: ICD candidates attending an outpatient preoperative clinic were invited to participate. Consented participants were randomized to standard care or standard care plus an educational intervention. The educational intervention addressing information gaps identified in the ICD literature was delivered during the preoperative visit. The primary outcome was feasibility with the following targeted rates, (1) 80% recruitment; (2) ≥ 95% consent; (3) 90% randomization; (4) ≥ 90% completion of questionnaires; (5) 80% of intervention sessions delivered less than 45 minutes; and (6) 90% of intervention content delivered. At baseline, demographic data and Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety scores were collected. Four weeks post-ICD implantation, participants completed the PROMIS anxiety measure, Florida Patient Acceptance Survey (FPAS), and Florida Shock Anxiety Scale (FSAS). Results: Twenty patients consented to the study (10 standard care/10 standard care plus the educational intervention). Feasibility outcomes achieved were, (1) recruitment rate of 80%; (2) consent rate of 87%; (3) 100% randomization; (4) 80% completion of questionnaires; (5) 100% of intervention sessions completed in less than 45 minutes; and (6) intervention checklist completion rate of 100%. The four-week mean (SD) FPAS scores were 80.0 (13.4) in the intervention group compared to 77.0 (16.5) in standard care. Mean (SE) four-week PROMIS scores were 45.4 (6.4) in the intervention group and 43.7 (8.6) in standard care. Mean FSAS (SD) scores were 14.7 (4.6) in the intervention group and 13.3 (3.9) in standard care. Conclusion: The results demonstrated feasibility of delivering a pre-implantation nurse-led educational intervention in an outpatient clinic setting to ICD candidates. Further studies to evaluate the effectiveness of the intervention on patient-reported outcomes are warranted. / Thesis / Master of Science (MSc) / An ICD is a medical device placed under the skin that can fix a dangerous heart rhythm. It can do so by shocking the patient’s heart if the ICD senses a dangerous heart rhythm. This study was done to determine if it is practical to deliver education to patients before they receive their ICD. Some patients feel they do not receive enough information before getting an ICD. No studies have tested how education before receiving an ICD can impact a patient’s quality of life. In this study, ten people received usual care while ten people received usual care and ICD education from a nurse before ICD implantation. The results of this study determined that it was practical for nurses to deliver ICD teaching before the ICD was implanted. A future study testing the impact of education on the quality of life of ICD patients can and should be completed.

Thermal preconditioning to simulate shipping, handling and storage conditions did not affect distal tip stiffness values for permanently implantable cardiac leads used for pacing and defibrillation. Leads that were subjected to extreme temperatures and temperature cycling did not show changes in buckle force values compared with control specimens which were maintained at ambient room conditions. Absolute differences between all measurements were small, generally under 0.05 N and were attributable to measurement variability. Buckle force values are used to assess the propensity of leads to perforate the heart, a rare but potentially serious complication of implantable pacing and defibrillation systems. Since preconditioning and buckle force measurement methods have not yet been standardized and no published studies exist, it was unknown whether and how much thermal preconditioning could affect lead buckle force. This study involved eight lead models from all four major lead manufacturers and included both pacing and defibrillation leads spanning a range of materials and construction methods. The preconditioning parameters used in the study, such as temperatures and cycle times, were derived from current industry methods. Knowing whether thermal preconditioning is critical to perforation propensity allows lead manufacturers and regulators to more efficiently direct resources towards ensuring reliability as well innovation. The results of this study can also inform the AAMI working group which is developing industry standards for transvenous pacing and defibrillation leads.

Varje år drabbas 10 000 människor av plötsligt hjärtstopp utanför sjukhus. De personer som överlever ett hjärtstopp kan bli aktuella för behandling med en Implanterbar Defibrillator (ICD).  Denna har funnits i bruk sedan 1980. Antalet implantationer ökar och utvecklingen går ständigt framåt. Sjukvården har en viktig roll i att stödja, utbilda och informera patienter och deras anhöriga så att de kan anpassa sig till det nya livet som ICD bärare. Syftet var att belysa ICD-bärares upplevelser av förändrad livssituation. Detta gjordes genom en litteraturstudie. Resultatet bygger på analys av åtta kvalitativa och tio kvantitativa vetenskapliga artiklar. Patienter med ICD upplever psykisk påfrestning, ett beroende av andra människor, att tvingas till levnadsförändringar samt acceptens till det nya livet som ICD-bärare. Implantation av en ICD innebär för många människor att få en ny chans till livet men det innebär också fysiska, psykiska och sociala omställningar i det vardagliga livet. Dessa omställningar påverkar också nära anhöriga. Eftersom antalet ICD implantationer ständigt ökar och det har visat sig att livssituationen på olika sätt förändras är det viktigt att omvårdnaden av denna patientgrupp präglas av individuellt stöd och utbildning i kombination av gott tekniskt kunnande för att underlätta anpassningen till livet som ICD-bärare. / Every year, there are 10 000 cases of sudden cardiac arrest outside of hospitals. Those who survive a cardiac arrest may be considered for treatment with an Implantable Cardioverter Defibrillator (ICD). The ICD has been in use since 1980 and the developments along with the number of implantations are continuously evolving. The health care system has an important role in supporting, educating and informing the patients and their families, to help them adapt to the new life as or with an ICD-bearer. The purpose of this study is to highlight the experiences and life alterations the ICD-bearer faces. The results are based on the analysis of eight qualitative and ten quantitative research articles. Patients with ICDs experience psychological distress; a dependence on other people; being forced to make life alterations and finding acceptance for the new life as an ICD-bearer. For many, an ICD is equivalent to a new chance at life, but it also represents every day physical, psychological and social changes. Changes that also affect close relatives. The care of these patients ought to be characterized by individual support and education, as the number of ICD implantations is constantly increasing and since it has been proven that life situations change. This in combination with good technical expertise facilitates the adaptation to life as an ICD-bearer.

Bakgrund: Tekniken utvecklas kontinuerligt och är idag ett vanligt inslag i sjuksköterskans dagliga omvårdnadsarbete. Patienter som vårdas av sjuksköterskan kommer också att komma i kontakt med tekniken och förståelse för patienters upplevelser är centralt för att sjuksköterskan ska kunna arbeta personcentrerat. Det är därmed väsentligt att belysa vad forskningen säger om hur patienter upplever att leva nära teknisk utrustning med anledning av att dessa patienter finns överallt i hälso- och sjukvården, och allmänsjuksköterskan kommer att komma i kontakt med dessa patienter.  Syfte: Syftet var att beskriva patienters upplevelser av att leva med en implanterbar kardiell defibrillator (ICD).  Metod: Litteraturöversikt med kvalitativ ansats baserad på 13 vetenskapliga artiklar från databaserna PubMed och Cinahl Complete. Artiklarna analyserades enligt Fribergs femstegsmodell för analys av kvalitativa studier.  Resultat: I litteraturöversiktens resultat presenterades tre teman och fem subteman. Patienter med ICD-behandling upplevde att kroppen med en ICD-dosa var förändrad. Relationen till livet förändrades och upplevelsen av chocken påverkade patienters mående. Patienter upplevde en brist på kunskap om hur ICD-behandlingen påverkade livet.  Slutsats: Patienter med ICD-behandling behövde anpassa sig till de förändringar och begränsningar som behandlingen medför. Hälso- och sjukvården behöver vara medvetna, ha förståelse och kunskap om förändringarna för att stödja och bevara hälsa och integritet, samt att begränsningar medför att relationen till samhället kan förändras. / Background: Technology is constantly developing and is now a common occurrencein the day-to-day work of a nurse. Patients who are in the care of anurse also come in contact with the technology, and being able tounderstand their experiences is key in allowing nurses to providepatient-centred care. It is therefore essential to highlight what researchsays about how patients experience living close to technical equipment,considering how these patients can be found everywhere in healthcare,and registered nurses will come in contact with these patients. Aim: The aim was to describe patients’ experiences living with an Implantable Cardioverter Defibrillator (ICD). Method: A literature review with a qualitative design based on 13 scientific articles from the databases PubMed and Cinahl Complete. The articles were analysed using Fribergs’ five step model for analysing qualitative studies. Results: In the literature review three themes and five subthemes were presented. Patient undergoing ICD-treatment experienced that their bodies felt different with the ICD-device. Their view of life changed as a result of the treatment and the shock of the defibrillation impacted their wellbeing. Patients experienced a lack of knowledge about how ICD-treatment affected their lives. Conclusion: Patients undergoing ICD-treatment needed to adapt to the changes and limitations that the treatment causes. The health care system needs to be aware of, have an understanding of and the knowledge of the changes in order to be able to support and maintain health and integrity. The limitations imposed a possible changing relationship with soceity.