The Role of the Nurse in Enhancing Quality of Life in Patients With an Implantable Cardioverter‐Defibrillator: The Swedish Experience

During the last 10-15 years, the implantable cardioverter-defibrillator (ICD) has become an important mode of treatment for patients suffering from grave ventricular arrhythmias, but ICD implantation involves psychosocial adjustments for both patients and relatives. The aim of this pilot study was to design a plan of education and to follow a selected group of patients with interviews, observations, and a questionnaire. The goals included seeing how well they accepted their situation after the operation when they had ongoing support of the nurse, in comparison to a control group who received conventional patient education by the physician. The patients were randomly allocated into two groups. Twenty patients were recruited, 10 in the study group and 10 in the control group, between February, 1997 and April, 1998. There were 16 men (average age, 63) and four women (average age, 57). The Nottingham Health Profile was used to measure health-related quality of life. Sleep disturbances were the greatest problem in both the study group and the control group before ICD implantation. In the study group, there was a significant improvement (p<0.05) after ICD implantation in four patients. The study also revealed a difference between men and women, with women having more sleep disturbances before ICD implantation than men (p<0.05). In both groups, there was a lack of energy and emotional reactions, both before and after ICD implantation. Few considered family life a problem before or after the study. In the control group, the patients missed the lack of contact with health care personnel more than in the study group. There was also a greater need for group meetings after the hospital stay. By means of the questionnaire, interviews, and observations, it became evident that there was a great need for information, and a plan of patient education in addition to follow-up by the nurse was felt to be very important.