EXPLORING INDIVIDUAL PERSPECTIVES WITH AN INSERTABLE CARDIAC MONITOR

ECU Author/Contributor (non-ECU co-authors, if there are any, appear on document)

Aprel Floyd Ventura (Creator)

Institution

East Carolina University (ECU )

Web Site: http://www.ecu.edu/lib/

Abstract: Cardiovascular disease (CVD) is the leading cause of death for men and women in the United States. Individuals with syncope , cardiac arrhythmias and cryptogenic stroke are at risk for CVD because of a suspected arrhythmia. These individuals may choose to have an insertable cardiac monitor (ICM) inserted to detect cardiac arrhythmia's such as atrial fibrillation (AF). Little is known about self-care , quality of life (QOL) and the experiences of those with an ICM. The purposes of this dissertation were to understand the experiences of individuals who have an ICM inserted and to describe the effect on their self-care and QOL. In this qualitative descriptive study , maximum variety sampling was used to recruit a diverse sample. Participants (N = 12) ranged in age from 41-95 , with half (n = 6) having the device because of syncope , infrequent AF (n = 1) , and others (n = 5) for device insertion due to having a cryptogenic stroke. Manuscript 1 examined the decision-making process for ICM insertion in those with suspected arrhythmias. Understanding the influences that occur early in this process are important for the clinician when discussing options with this population. The purpose of this study was to describe how individuals make a decision to have an ICM inserted. The decision-making process to have an ICM inserted varied among participants. Three global categories emerged with data analyses: (a) pre-decision , (b) definitive decision , and (c) deliberated decision. Event symptoms , including physical , cognitive and emotional symptoms , and trust emerged as factors in the decision-making process. Finding from this study indicate that clinicians should explore loss and emotional symptoms when caring for those making the decision to have an ICM. Because the timing of the decision varied and was related to trust , further research is needed to address the qualities that are important in interactions between the individual and their clinician that influence trust. Manuscript 2 focused on understanding the experiences of those with an ICM to improve health outcomes and QOL. The purpose of this study was to describe the experiences of those with undiagnosed cardiac symptoms or post-cryptogenic stroke living with an ICM. Data analyses resulted in three global categories: (a) influences on self-care , (b) managing , and (c) monitoring. Findings indicate that communication by the remote monitoring staff is an important aspect for those with an ICM. Future studies are warranted to determine the type and frequency of communication needed. Future studies are also needed to address fatigue and the importance of spiritual wellness in this population.

Additional Information

Publication

Dissertation

Language: English

Date: 2017

Keywords

Cardiovascular disease, insertable cardiac monitor, individual perspectives

Subjects

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