Bilaga 2
Tabell 2. Artikelmatris
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(art. 1)
Malm D and Hallberg L. Sweden
2006
Patients’ Experiences of Daily Living with a
Pacemaker A Grounded Theory Study
The aim of this study was to examine patients’ experiences of daily living with a pacemaker Quantitative.
The grounded theory method was the basis for collection and analysis of the data.
Semistructured interviews. Most of the interviews (12) were conducted at the informants’ homes, while one took place at the infor- mant’s place of work. Participants for the The study was carried out using patients with pacemakers in a health care area in southern Sweden, all of who had had the pacemaker implanted at the same county hospital. The participants were selected according to maximum variation sampling technique, using the variables age, sex, number of years with a
pacemaker and pacemaker mode in order to get as broad a range as possible of patient experiences.
13 pacemaker patients (seven women and six men) aged 22–82 (mean = 59.2) years. . The informants had had a pacemaker from 0.5 to 33 (mean 13.1) years.
<5 % 1, "Limited participation " and "participations at equal terms" in different activities. 2, Emotionell state that are characterised by variations between the sence of “sequrity” and “unsequraty”. 3, The sence of being treated by too much carefulness by the relatives. 4, The experience of insuffience in different adequate and not dangerous for them. 5, planning the day all along the line that are adequate for them. 6, A strong feeling of being able to going back to the normal life they had before. 6, Restriktions. Planning there everyday life from there
understanding of what is secure for them.
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(art. 2) Mickley H, Petersen J, Nielsen B 1989 DENMARK Subjective Consequences of Permanent Pacemaker Therapy in Patients Under the Age of Retirement
The aim of this study was to investigate patients' perceptions of the effects of pacemaker treatment. Quantitative. semi-structured questionnaire regarding subjective consequences of pacemaker therapy was sent to the 72 survivors. Telephoned the patients giving a further chance to explain about the study and clarify possible indistinctness. Statistical comparisons were made using the chi square test. 5-year period.
72 patients in the occupationally active age defined as being 20 to 60 years old
< 5% 1, Symptoms. 93,1% felt an inprovement or a complete sence of reliase from there symptomes. 2, (11,1%) felt worried or uncetain as a carrier of a pacemaker.3, Two were afraid of trauma to the puls generater.4, Four of them had a fear of pacing failure. 5, 76,4% of the patients felt no physical uneasiness fom the pacemaker. 6, Five patients felt ”mechanic” uneasiness ( pain or soreness in the scar, clothes and seatbelts gave a sense of irritation at the aerea. 7, Two of the patients avoid places were there are or can be microwaweowes or weapondetectors. 8, Dislike the feeling of an unknown object in there body. 9, (68,1%) pacemakertreatments had not affected there sexual life. 10, Improves sexlife. Six patients or 8,3% experiensced an inprovement.11. A deteriorate of the sexlife was experienced by six patients. 11,b, Quality of life. Thirty patients (41,7%) did not experience any effect.12, 43% of the patients experienced an inprovement of there quality of life. 13, 13,9% experienced a deteriorating quality of life.
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(art. 3) Anderson C 2003 Australia The postmodern heart: war veterans’ experiences of invasive cardiac technology
The aim of this study was to answer the question, ‘How does the war veteran experience his body in relation The aim of this study was to invasive cardiac technology?’.
Qualitative
Unstructured face-to-face interviews. The interviews were Audiotaped and transcribed the tapes verbatim. Thematic analysis and interpretation, temporal mapping and the criteria for analytic interpretation were combined.
8 male, war veterans. Over 65 years old.
<5 % 1,Change in body image. 2, Awerenss of their own mortaity 3, New meaning of life 4, Emotional support in medicine knowledge. 5, Worries about the battery 6, Sence of dependence 7, Want to believe the heart is repared. 8, Fine line between life and death. 9, Life and death is being controlled by the heart and the pacemaker. 10, Pacemaker as a miracle. 11, Loss og self-control. 12, Pacemakern is a friend and an enemy. 13, Trying to get a human relation to the pacemaker. 14, Avioding electromagnetic fields. 15, Limits in daily social interactions. 16, Pacemakern is not always ”nice”. 17, Experiencing the surgery as a greater surgery than they’ve been told. 18, Increased awereness of their bodies.19, Destruction in the roles as a man, a husband, a father and a social being. 20, The relation to ”sence of control” in their life was changed. 21, Extreme anxiety because of the sence of power.
83 %, grade 1
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(art. 4) Duru F, Büchi S, Klaghofer R, Mattmann H, Sensky T, Buddeberg C, Candinas R 2001 Switzerland
How different from pacemaker patients are recipients of implantable cardioverterdefibrillators with respect to
psychosocial adaptation, affective disorders, and quality of life?
The aim of this study was to assess differences in psychosocial adaptation, quality of life, and incidence of affective disorders between patients with pacemakers and those with implantable cardioverter- defibrillators (ICDs).
Quantitative.
Questionnaires, which were mailed to them. Hospital anxiety and depression scale (HAD), the short form general health survey (SF-36), and a specially designed device related questionnaire. Data analysis was performed for three patient groups: pacemaker (n = 76), ICD patients who received therapeutic shocks (n = 45), and ICD patients who did not receive shocks (n = 31).
76 Patients aged 40–70 years who underwent a first pectoral
implantation of a pacemaker were studied.
>20 % 1, Sees the pacemaker as a life extender. 2, Worried that the battery power is out. 3, Worried about technical errors. 4, Does not feel the need of a support group. 5,
Improves health-related life quality. 6, Moderate sence of low spirit with 19,1 % and 10,7% were clinically depressed.
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(art. 5) Aqeel M, Shafquat A, Salahuddin N 2008 Pakistan Pacemaker patients' perception of unsafe activities: a survey
The aim of this study was to determine if routine activities are perceived by pacemaker patients to interfere with their device function. Quantitative.
Descriptive cross sectional survey. 47-question tool was developed and tested. Patients' perceptions of safety of performing various routine activities, along with socio- demographic data were recorded.
93 adult patients (above 18 years) from the pacemaker clinic at a public hospital in Karachi, Pakistan
>20 % 1, Can not sleep on the same side as tha pacemaker is placed. 2, Can not bend over. 3, Feeling many daily activities is dangerous. 4, Trying to avoid electrical household goods. 5, 77,4% different advices given. 6, The experiences are not different wether you’re able to write or read, or not. 7, The level of income does not affect patients
81 %, grade 1
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(art. 6) Davis L, Vitale K, Irmiere C, Hackney T, Belew K, Chikowski A, Sullivan C, Hellkamp A, Schron E, Lamas 2004 USA Body image changes associated with dual- chamber pacemaker insertion in women
The aim of this study was to examine the body image changes in adults who had received permanent pacemakers.
Quantitative and Qualitative. The concepts for the questionnaire were opera- tionalized with 4 Likert-type scale items. Provisions were made to allow for space to write in additional comments at the end of the questionnaire. The questionnaire was designed to be self-administered and took between 3 and 10 minutes to complete.
383 adults, all of whom had received a dualchamber
pacemaker. 192 (50%) Female, 191 (50%) Men.
>20 % 1, The majority of the patients (73,2 %) did not declare change in body image. 2, Placement and scaring didn’t matter (87,1%). 3, 92 % felt the pacemaker implant hadn’t affected the way they dressed. 4, Most patients (93,5%) declared their partners had not change their view of their bodies. 5, Women were more worried than men about their pacemaker and the scar. 6, Men were more worried then women about how they would be seen after the
pacemaker implant. 7, Younger patients (age under 75 years old) declared a higher level of worrieness to wear a swimsuit. 8, Younger (under 75 years old) were more worried than patients over 75 years old, of how their partners would see them. 9, A positive adaption to their body 10, Women were more worried about the placement of the scar and the way the implant had change their body, than the pacemaker itself 11, If also the partner had a pacemaker it was easier to accept the change 12, General discomfort of the placement of the pacemaker. 13, Hurts to sleep on their left side. 14, Experiencing discomfort when wearing a seat-belt. 15, Discomfort is worse in wet days. 16,
Forgetting the pacemaker. 17, Relatives worries has decreased after five to six month. 17, Could not wear certain. 18, Designed their own band aid.
81 %, grade 1
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(art. 7) Beery T, Sommers M, Hall J 2002 USA Focused Life Stories of Women With Cardiac Pacemakers1
The aim of this study was to explore women’s response to pacemaker implantation.
Qualitative using Hall’s focused life stories design. The
participants were asked to describe their experiences using semistructured interviews. The
research questions were, “What is the experience of women living with permanent cardiac pacemakers?” and “How do women incorporate permanent cardiac pacemakers into their lives and bodies?”
11 women from teenagers to elders with permanent cardiac pacemakers
>20% Powerless in health care, taking power over their pacemaker, experiencing fear, body image, normalize the role as a parent, the power within and regaining power.
85 %, grade 1
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(art. 8) Udo E, HemelN, Zuithoff N, Nijboer H, TaksW, Doevendans P, Moons K. 2012 Netherlands Long term qualityof-life in patients with bradycardia pacemaker implantation
The aim of this study was to examine the Health related Quality of life over time in patient with pacemaker implantation.
Quantitative
Using the generic SF-36 and the PM specific Aquarel
questionnaire, HRQoL (Health related Quality of life) was repeatedly measured during a 7.5 year follow-up period. HRQoL over time, corrected for age, gender, diabetes, hypertension, heart failure, cardiovascular disease and AV-synchrony, was assessed with a linear mixed model.
881 bradycardia Pacemaker recipients
>20 % 1, Increased health-related life quality with a pacemaker. 2, The social function, limits in their family-role general mental health and the vitality improved immediately after the surgery. 3, The physical function was improved directly after the pacemaker implant, but three years after the surgery the physical function was lower than before the surgery. 4, Role limitations, emotional problems, social function and the mental health were strongly improved after pacemaker surgery. Good results even 7, 5 years after the surgery. 5, Pain after surgery. 6, decreased discomfort in the chest area. 7, Experiencing it hard to breath after activity after the surgery 8, Men experienced after 7,5 years a greater improvement than women. 9, People over 75 years old by the time of the implant had a lower quiality of life than those who had their surgery when they were under 75 years of age.
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(art. 9) Locsin R, Campling A, Purnell M, Tulloch S, Kissel K, Wilson G. 2010 USA The Lived Experience of Persons with Life- Sustaining Cardiac Devices
The purpose of this study was to describe the experience of persons with permanent im- plantable cardiac devices. Qualitative
Purposeful sampling was by snowball method. Interviews were guided by semistructured questions, conducted via the tele- phone, and electronically recorded.
3 recipients with a permanent cardiac pacemaker device. Two men ages 42 and 60 and one woman, age 45.
>20 % 1, Sence of dependence to the pacemaker. 2, Feels like magic 3, Has more energy 4, Making it possble to continue life. 5, Improved physical shape. 6, A new chance to a new life. 7, Experiencing faith and inspiration to the life with a pacemaker. 8, Starting to see the value in small things in life. 9, Feeling better leading to improved motivation and
inspiration to live. 10, Feeling better and looking better. 11, Working better han expected in
electromagnetic fields. 12, The
patient is looking better and healthier. 13, Being aware of life and death
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(art. 10)
Hoth K, Nash J, Poppas A, Ellison K, Paul R, Cohen R 2008 USA Effects of cardiac resynchronization therapy on healthrelated quality of life in older adults with heart failure
The aim of the study was to examine changes in health-related quality of life among older adults undergoing cardiac resynchronization therapy (CRT), a pacemaker based inter- vention for heart failure.
Quantitative
Using the generic SF-36 and a 6minute walk test at baseline and 3 month follow up. Descriptive statistics regarding the sample demographic and medical characteristics were calculated. the primary analysis to examine change in health-related quality of life included eight paired t-tests to compare patients’ self-reported quality of life on each of the SF36 scales at baseline and 3-months post-CRT.
21 pacemaker over the age of 55, who were candidates for cardiac resynchronization therapy.
5-20 % 1, Physically stronger. 2, Increased vitality. 3, Reduction of heart desease-symptomes 4, Able to walk faster after the pacemaker implant 5, Significant connection between age and the physical improvement. 6, Younger patients experienced less pain after the pacemaker. 7, Patients with higher BMI had a reduced improvement in their physical function.
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(art.11) Fleischmann K, Orav J, Lamas G, Mangione C, Schron E, Lee K, Goldman L. 2006 USA Pacemaker implantation and quality of life in the Mode Selection Trial (MOST)
The purpose of this study was to assess the effect of pacemaker implantation, clinical factors, and pacing mode on QOL (quality of life).
Quantitative
QOL was assessed with the 36Item Short-Form. eight healthrelated QOL domains: physical function, physical role, social function, emotional role, mental health, vitality, bodily pain, and general health perception. Data was colected on baseline, 3 month, one year and two years after receved pacemaker.
2,010 patients older than 21 years with sick sinus syndrome who were in sinus rhythm and had standard indications for pacemaker implantation but no serious comorbid illness. Average eage 73 years. 52% male.
<5 % 1, Significant improvement in SF-36 protocol after surgery (physical function, physical role, social function, emotional role, mental health, vitality and pain). 2, A significant improvement in activity in patients younger than 75 years old. 3, The improvements were good, no matter sex, co-morbidity or earlier state of heart failure
