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Asian Journal of Nursing Education and Research
Year : 2020, Volume : 10, Issue : 4
First page : ( 463) Last page : ( 470)
Print ISSN : 2231-1149. Online ISSN : 2349-2996.
Article DOI : 10.5958/2349-2996.2020.00099.3

Physical and psychosocial concerns among patient living with implantable cardioverter defibrillator attending tertiary health care facility

Mathew Jane1, Sharma Ankita2, Naik Nitish3, Gopichandran L.4

1M.Sc. Student, College of Nursing, AIIMS, New Delhi

2Nursing Officer, Department of Cardiology, AIIMS, New Delhi

3Professor, Department of Cardiology, AIIMS, New Delhi

4Associate Professor, College of Nursing, AIIMS, New Delhi

Online published on 27 April, 2021.

Abstract

Introduction

With the rise in dependent population living with implanted cardioverter defibrillator, it’s crucial to explore their physical and psychosocial concerns. Once the device is implanted, patient has to learn to live with it. This concerns often decreases the device acceptability.

Objectives of The Study

To examine the specific implanted device related physical and psychosocial concerns in patients living with ICD. As well as to find correlation of these factors with demographic and clinical profile.

Material and Methods

Quantitative, descriptive, cross sectional study was conducted. Ethical permission was obtained. Consecutively, 60 medically stable ICD patients were taken for the study. Demographic profile, clinical profile, Florida patient acceptance survey, Florida shock anxiety scale, physical concern questionnaire were administered via interview technique. Time taken from each participant varies between 25-30 minutes.

Results

Physical concerns assessment showed a mean burden score of 2.72+/-2.16, 31.7% had inadequate knowledge. Therapy shock related symptoms were predominantly felt as chest pain (46.70%) of moderate intensity and as jumping of the chest (63.3%), mean pain scale score was 5.50+/-2.21 and the pain lasted for less than 5 minutes (79%). Majority of the subjects were able to resume activity within an hour of therapy shocks. Lesser device acceptance scores (71.22+/-17.06) and greater anxiety scores (17.12+/-7.40) were seen among the subjects. Great symptom burden scores are associated with lower NYHA class (p=0.001), remote accessability to healthcare (p=0.001), greater duration of implantation (p=0.02), great number of therapy shocks (p=0.001) and lower BMI (p=0.037). Lesser acceptance scores were associated with young age (p=0.009), NYHA class (p=0.04) and number of therapy shocks (p=0.005). Greater pre pre-shock anxiety were found in subjects who have experienced greaternumber of therapy shocks (p=0.000), with lesser BMI (p=0.03) and lower educational qualification (p=0.03).

Conclusion

The concern among ICD recipients in itself is complex field of study that can be affected by several factors other than symptom burden, pre-shock anxiety and device acceptance. The results showed that the patients were living with various physical and psychological problems and insufficient knowledge regarding the ICD.

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Keywords

Implantable cardioverter defibrillator (ICD), Physical concerns, Psychosocial concerns.

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