The postmodern heart: war veterans' experiences of invasive cardiac technology

J Adv Nurs. 2004 May;46(3):253-61. doi: 10.1111/j.1365-2648.2004.02985.x.

Abstract

Background: The consequences of war and medical discourse have historical connections to pacemaker technology. Understanding these consequences is important because war veterans, medicine and cardiac technology have a shared history that continues into the present. The incidence of Australian war veterans needing cardiac pacemakers has increased many-fold in recent years, due to advancing age. This need was recognized by the Australian Department of Veteran Affairs and a cardiac programme was established in the veteran hospital that was the setting for this study.

Aim: This paper reports on a study aimed at capturing the interest and sensitizing the practice of nurses involved in the care of war veterans and other health care consumers who have been diagnosed as requiring a cardiac pacemaker. The study sought to answer the question, 'How does the war veteran experience his body in relation to invasive cardiac technology?'.

Method: The research was guided by the principles of interpretive interactionism, and used unstructured interviews with eight male war veterans. The data were collected in 2000.

Findings: Thematic and content analysis revealed five themes: emotional knowing; the medical encounter; belief in the myth of miracle; technological constraint; and the altered heart. The findings indicated that the human dimension was characterized by experiences of ambivalence, inner conflict, powerlessness and suffering.

Conclusion: Nursing is at the interface of science and patient care, and this study contributes to nursing knowledge by focusing on a previously unresearched topic, namely embodied interactions between war veterans and invasive cardiac pacemakers. Within a highly technical area such as cardiology, nurses can still work around the technology and keep patients as their primary focus, thus promoting quality care. A humanistic rather than a technological focus locates nurses between patients and cardiac technology. In this in-between location, nurses are not an extension of cardiac technology but a valuable source of information, education, and counselling.

MeSH terms

  • Adaptation, Psychological
  • Aged
  • Australia
  • Biomedical Technology / methods
  • Counseling / methods
  • Heart Diseases / nursing
  • Heart Diseases / psychology*
  • Heart Diseases / therapy
  • Humans
  • Male
  • Nurse's Role / psychology
  • Pacemaker, Artificial / psychology*
  • Veterans / psychology*
  • Warfare