The educational experiences and needs of patients with an internal cardiac defibrillator: An interpretive phenomenological study

Abstract

<h2>ABSTRACT</h2><h3>Background</h3> Internal cardiac defibrillators (ICD) are the treatment option for primary and secondary prevention of sudden cardiac arrest and potential death. The majority of research to date has focused on the psychological and physical outcomes affecting patients, such as fear, anxiety, depression, and changes in quality of life post ICD insertion. There is, however, limited research exploring the adequacy of their educational preparation by nurses and other health care professionals. <h3>Aim</h3> The aim of this study was to understand the educational experiences and needs of adult patients with ICDs within a metropolitan tertiary hospital in Queensland. <h3>Methods</h3> An interpretive phenomenological approach was chosen to explore the everyday educational experiences and needs of patients with an ICD or Subcutaneous Internal Cardiac Defibrillator (S-ICD). Semi-structured interviews were conducted with a purposive sample of ten participants until data saturation was reached. Thematic analysis was used to analyse the data. <h3>Findings</h3> Five themes emerged and these were ‘understanding the information needs of patients'; ‘psychological aspects'; ‘fearful of the ICD shock'; ‘physical concerns'; and ‘importance of family inclusion'. <h3>Discussion</h3> The study's findings revealed that patients with ICD/S-ICDs had unmet educational needs that are important for nurses to understand and address. These specifically related to education and the relevance to each individual's particular needs. These included addressing their anxiety levels explaining changes to everyday activities and including family in the education sessions. Discharge care via telemonitoring may be useful for follow-up care for this unique and vulnerable patient group. <h3>Conclusion</h3> Interpretive phenomenology was used to understand the experiences and needs of people living with an ICD/S-ICD. This study has provided knowledge about the patient's desire for clarity of information relevant to their individual needs. The research found that patients with ICD/S-ICDs did not perceive the education that they received regarding the device to be adequate, nor did it address their specific needs. The research highlighted that nurses caring for patients undergoing ICD/S-ICD insertion need to provide education that is both patient and family specific, and that it continues for at least two months post-hospital discharge.