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  • 1.
    Flemme, Inger
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Edvardsson, Nils
    Division of Cardiology, Sahlgrenska University Hospital.
    Hinic, Hansi
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Jinhage, Britt-Marie
    Division of Cardiology, Sahlgrenska University Hospital.
    Dalman, Margareta
    Division of Cardiology, Sahlgrenska University Hospital.
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Long-term quality of life and uncertainty in patients living with an implantable cardioverter defibrillator2005In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 34, no 6, p. 386-392Article in journal (Refereed)
    Abstract [en]

    Purpose: This study describes the quality of life (QOL) and uncertainty in patients who have an implantable cardioverter defibrillator (ICD) and predicts QOL at long-term follow-up.

    Methods: Long-term follow-up was defined as 6.9 years ± 1 year (range 4.11–8.7 years). QOL was measured with the Quality of Life Index, and uncertainty was measured with the Mishel Uncertainty in Illness Scale.

    Results: The overall QOL and health/functioning were unchanged over time. QOL in the socioeconomic (P = .002) and psychologic/spiritual domains (P = .012) decreased in the first year. From baseline to long-term follow-up, the QOL in the family domain (P = .011) and uncertainty (P = .002) decreased. Uncertainty was a predictor of low QOL.

    Conclusion: QOL was reasonably good 6.9 years post-ICD implantation. Patients felt less uncertain once they had passed the first year of their illness.

  • 2.
    Flemme, Inger
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI), Group for Research on health promotion and disease prevention.
    Hallberg, Ulrika
    Nordiska hälsohögskolan, Göteborg.
    Johansson, Ingela
    Hälsouniversitetet, Linköping.
    Strömberg, Anna
    Hälsouniversitetet, Linköping.
    Uncertainty is a major concern for patients with implantable cardioverter defibrillators2011In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 40, no 5, p. 420-428Article in journal (Refereed)
    Abstract [en]

    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.

  • 3.
    Fluur, Christina
    et al.
    Department of Cardiology UHL, County Council of Östergötland, Linköping, Sweden.
    Bolse, Kärstin
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Strömberg, Anna
    Division of Nursing Sciences, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Sweden.
    Thylen, Ingela
    Department of Cardiology, Linköping University Hospital, Linköping, Sweden.
    Patients' experiences of the implantable cardioverter defibrillator (ICD); with a focus on battery replacement and end-of-life issues2013In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 42, no 3, p. 202-207Article in journal (Refereed)
    Abstract [en]

    Background: ICD deactivation at end-of-life is technically uncomplicated. However, it may present a psychological challenge to healthcare professionals, patients, and next-of-kin. Objective: This study explored patients' experiences of complex issues of battery replacement and deactivation of the ICD. Methods: Semistructured interviews were administered to 37 medically stable ICD-recipients. Results: The ICD-recipients lived with an uncertain illness trajectory, but the majority had not reflected on battery replacement or elective ICD deactivation. Healthcare professionals had rarely discussed these issues with patients. However, this was consistent with the ICD-recipients' wishes. Many patients had misconceptions about the lifesaving capacity of the ICD and the majority stated that they would not choose to deactivate the ICD, even if they knew they were terminally ill, and it meant they would receive multiple shocks. Conclusion: The ICD-recipients tended not to think about end-of-life issues, which imply that many patients reach the final stages of life unaware of the option of ICD deactivation. © 2013 Elsevier Inc.

  • 4.
    Hildingh, Cathrine
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Lidell, Evy
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Women's experiences of recovery after myocardial infarction: a meta-synthesis2007In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 36, no 6, p. 410-417Article in journal (Refereed)
    Abstract [en]

    Background: Women report lower well-being, compared with men, during recovery after myocardial infarction (MI). To support women in their recovery it is important to understand their experiences from their own perspective. However, a single study using a qualitative method does not have the potential to contribute to evidence-based nursing practice, and it is therefore important to synthesize findings from several qualitative studies. Objectives: The aim of this study was to perform a meta-synthesis of findings of women's experiences of recovery after MI. Methods: A meta-synthesis with seven qualitative studies, including a total of 70 women, was performed. Results: Recovery was characterized by subordination and superordination. The women strived to preserve their self, and at the same time they were strongly oriented toward other people. Four concepts emerged: protecting, adjusting, downgrading, and succumbing. Conclusion: Women oscillate between subordination and superordination. Protecting the matriarchy and being a victim of the patriarchy shed light on this ambivalence in the same way as adjusting to the situation and succumbing to the disease do.

  • 5.
    Mårtensson, Jan
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Dracup, Kathleen
    School of Nursing, University of California, San Francisco.
    Fridlund, Bengt
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Decisive situations influencing spouses' support of patients with heart failure: A critical incident technique analysis2001In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 30, no 5, p. 341-350Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    The aim of this study was to describe decisive situations experienced by spouses of patients with heart failure that could potentially affect their ability to provide social support to the patient.

    METHODS:

    A qualitative descriptive design with a critical incident technique was used. Twenty-three informants, 15 women and 8 men, who were spouses of patients with severe heart failure were strategically chosen to ensure maximal variation in sociodemographic data and experiences as a spouse.

    RESULTS:

    Decisive situations influenced the experience of spouses of patients with heart failure in a manner that was either positive (involvement with others) or negative (feeling like an outsider). When spouses were given attention and treated like persons of value, they experienced involvement with others. In these cases, spouses had someone to turn to and were included in the physical care. In contrast, when spouses were kept at a distance by the patient, were socially isolated, and received insufficient support from children, friends, and health care professionals, they experienced feeling like an outsider.

    CONCLUSIONS:

    By identifying spouses' experiences, health care professionals can assess which kind of specific interventions should be used to improve the life situation of the patient with heart failure and his or her spouse.

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