OBJECTIVE: The study objective was to explore the main concern of individuals living with an implantable cardioverter defibrillator (ICD) and how they handle this in daily life. For improved management and follow-up, it is important to understand how the ICD affects the recipient's daily life. METHODS: A grounded theory method was used. Sixteen Swedish recipients (9 men) living with an ICD for 6 to 24 months were interviewed. RESULTS: The core category labeled, "Incorporating uncertainty in daily life," illuminates the main concern. To handle uncertainty, recipients used the following strategies: restricting activities, distracting oneself, accepting being an ICD recipient, and reevaluating life. CONCLUSION: Recipients were not paralyzed by uncertainty. Instead, they incorporated uncertainty in life by using strategies to handle their daily life. Questions, comments, and plans for supportive communication were provided, which can be used by healthcare professionals in cardiac rehabilitation.

Developing Grounded Theory. The Second Generation is a very useful and clarifying book arisen from a one-day symposium on advances in qualitative methods in Alberta, 2007. The conference was sponsored by the International Institute for Qualitative Methodology (IIQM). For the first time, the students of Barney Glaser and Anselm Strauss, “the second generation” of grounded theory researchers, met to discuss grounded theory and its developments. With the exception of Janice Morse, the authors of this book worked directly with Anselm Strauss and Barney Glaser. In this volume they provide a description of the history, principles and practice of the grounded theory methods.

Background:

the implantable cardioverter defibrillator is a sophisticated and multifunctional device to treat life-threatening arrhythmias. With increasing numbers of recipients implanted due to rapid technical development of devices and enlarged implantation indications, the consequences for recipients with an implantable cardioverter defibrillator daily life has attracted increased attention during the last decade.

Aim:

to illuminate the main concern of individuals living with an implantable cardioverter defibrillator and how they handle this in their daily life.

Design and method:

the grounded theory method was used. Sixteen Swedish recipients (9 men) who had lived with a defibrillator for 6 to 24 months were interviewed. Data was collected and analysed in a simultaneous process according to guidelines for classic grounded theory. 

Results:

in the analysis, a conceptual model was generated explaining the main concern of recipients with an implantable cardioverter defibrillator and how they handle this in their daily life. The core category, labelled "Living with uncertainty" illuminates the main concern of the recipients. To handle uncertainty the recipients used the following strategies: Restricting one’s activities, Distracting oneself, Accepting one’s fate and Re-evaluating one’s life.

Conclusions:

Recipients with an implantable cardioverter defibrillator were not paralyzed by the uncertainty they experienced. Instead, they handled the uncertainty by using different strategies which may produce a sense of perceived control to initiate a living process that facilitates physical and social activities.

Relevance to clinical practice:

this study suggests that nurses should support recipients with an implantable cardioverter defibrillator to handle uncertainty and contribute by optimizing the recipients sense of perceived control in daily life and thereby personal growth.

Background: Earlier studies have shown that individuals with implantable cardioverter defibrillator (ICD) experience fear, stress, anxiety, and depression in their daily life, but also feelings of gratitude, safety, and belief in the future. Uncertainty and restrictions in physical, psychological and social functioning are common responses to their experiences. Aim: The aim of the study was to illuminate the main concern of individuals living with an ICD and how they handle this in their daily life.

Method: Sixteen Swedish recipients (9 men) who had lived with a defibrillator for 6 to 24 months were interviewed during 2007. Data was collected and analyzed in a simultaneous process according to guidelines for classical grounded theory.

Results: In the analysis, a substantive theory was generated explaining the main concern of ICD recipients and how they handle this in their daily life. The core category, labelled “Striving to resume command” illuminates the main concern of ICD recipients. To manage this main concern, the recipients used the following strategies: Economizing resources, Distracting oneself, Submitting to one’s fate and Re-evaluating life.

Conclusions: Based on empirical data, a substantive theory was generated illuminating the main concern for ICD recipients and strategies they used to manage this in daily life. The theory deepens the understanding of the recipients´ striving to resume command over their lives in an ongoing adjustment process which they have to face. This knowledge has clinical relevance and suggests that nurses should support the ICD recipients in this respect and thereby contribute to optimizing their sense of control in daily life. Future research could focus on the role of family members of ICD recipients and in what way they can support rather than overprotect their closely related.

Living with a child with a disability is often perceived as a permanent stressor to the family and it affects all aspects of family life including the well-being of family members. Since little is known about parenting teenage daughters diagnosed with ADHD, the aim of the study was to gain a deeper understanding of the main problem involved using a grounded theory approach. Interviews were carried out with 12 parents, 11 mothers and 1 father, of teenage daughters diagnosed with ADHD. The parents' situation was conceptualized as living at the edge of one's capability with the properties having the sole parental responsibility, fighting for professional support, being on duty around the clock and trying to solve family conflicts. Parents described how their health was negatively affected by their life situation.

Purpose:

The aim of the study was to explore and gain an understanding of patients' views on their periodontal conditions, their perceived impact of periodontitis on daily life, as well as their attitudes to oral health and expectations of treatment.

Materials and Methods:

The study subjects were patients with chronic periodontitis, who had been referred to a specialist clinic. The constant comparative method for grounded theory was used to collect and analyse the data. Audiotaped, open-ended interviews were conducted after periodontal examination, but before treatment. The interviews were transcribed verbatim and consecutively analysed in hierarchical coding processes and continued until saturation was reached (n = 17). In the analysis, a conceptual model that outlined the steps involved in the diagnosis of periodontitis was generated. The core concept of the model, keeping up appearance and self-esteem, was related to the following four additional categories and their dimensions; doing what you have to do trying to live up to the norm, suddenly having a shameful and disabling disease, feeling deserted and in the hands of an authority, and investing all in a treatment with an unpredictable outcome.

Results:

The results illustrated that subjects diagnosed with chronic periodontitis felt ashamed and were willing to invest all they had in terms of time, effort and financial resources to become healthy and to maintain their self-esteem. However, they perceived a low degree of control over treatment decisions and treatment outcome.

Conclusions:

The results demonstrate the vulnerability of patients diagnosed with chronic periodontitis and emphasise the importance of communication in dentistry.

PURPOSE. The aims were to (i) translate the Amsterdam Inventory for Auditory Disability and Handicap (AIADH) into Swedish and evalute its usefulness, (ii) describe hearing difficulties and psychological well-being (quality of life) and (iii) explore variables related to psychological well-being in a Swedish population. METHOD. Seventy-nine consecutive patients, referred to the hearing clinic for hearing examination and audiological rehabilitation, formed the study sample. Along with pure-tone audiometry, the AIADH, the Psychological General Well-being index and the Communication Strategies Scale were used. RESULTS. Men had significantly worse hearing on the high frequencies (2, 3, 4 and 6 kHz) than women but their quality of life was significantly higher than for women. Men scored significantly lower on 'auditory localization' and adopted non-verbal communication strategies less often than women. A stepwise regression analysis showed that 'maladaptive behaviours' and 'intelligibility in quiet' explained 48% of the variance in quality of life. CONCLUSION. Psychosocial consequences of hearing loss, such as lowered quality of life, cannot be predicted from audiometric data alone. The adverse relationship between maladaptive behaviour and quality of life emphasizes the relevance of developing training programs aiming to improve coping with the consequences of a hearing impairment.The AIADH may be useful in assessing self-reported difficulties among patients with hearing problems, but needs to be further developed in terms of psychometric evaluations and reliability testings based on a larger representative sample.

The aim of this study was to gain a deeper understanding for the main concern of indivi­duals living with an implantable cardioverter defibrillator (ICD) and what they did to hand­le it. The study group consisted of 16 patients, who had experienced a cardiac arrest or life-threatening arrhythmias, with a mean age of 56 years. In-depth interviews, con­duc­ted 6-24 months after ICD implant, were analysed using the grounded theory method. Four emergent categories were labelled economizing resources, distracting oneself, sub­mitting to one’s fate and re­valuing life. The core category, striving to resume command of one’s life, describes the uncertain process of living with discomfort of not knowing. The participants economized with their limited resources by restricting and planning every day and distracted themselves by divert attention away from the problems at hand and en­gaged physically or mentally in something else. They felt omitted when they could not in­fluence their situation and what happened to them. They had no or little control over the disease and the device and must accept physical and social changes. As time had passed, they were grateful for having survived, felt secure and accepted the ICD treatment. How­ever, a subgroup that had experienced complications as ICD shocks had hard to accept the changed life situation.

OBJECTIVE.

Our knowledge of how people with disabilities look upon oral health and dental care is limited. The aim of this study was thus to explore how the people with disabilities experience the encounter with dental health care.

MATERIAL AND METHODS.

With a focus on dental care and oral health, qualitative interviews with 16 informants with cognitive and/or physical disabilities were analysed in accordance with the qualitative method of grounded theory.

RESULTS.

A core category identified and labeled “giving low priority to oral health care” was found to be related to four other categories: “being afraid of losing control”, “having difficulties complying with instructions”, “having a desire for continuity”, and “wishing to be just like everyone else”. The results show that oral health and dental care are important, but are not considered a priority by the people with disabilities. General health issues have much higher priority but do not include oral health, which consequently can affect oral health negatively.

CONCLUSIONS.

Of several factors identified that could be improved to make dental visits more pleasant for patients are enhancing a sense of control in the patient and improving continuity.

The aim of this study was to explore what dentition and oral health mean to adult dental care patients' well-being. Qualitative, taped interviews were conducted with 15 participants (over 20 years of age), who were patients at private and public dental health care units in the western part of Sweden. The constant comparative method of grounded theory was used. The interviews were consecutively analyzed in hierarchical coding processes until saturation was achieved. A conceptual model was generated illuminating the meaning of dentition and oral health for the participant's well-being. The core category of the model, struggling to optimize one's self-esteem, was related to four categories, which further described the psychosocial process of increasing one's self-esteem and contributing to well-being. These categories were labelled investing in oneself, being attractive to others, being able to socialize and showing ones social belonging. People who are satisfied with their teeth in terms of function and appearance seem to have developed an optimized self-esteem, which contributes to the well-being in individuals. Consequently, inequalities in oral health according to social belonging may lead to inequalities in self-esteem and well-being.