Elsevier

Heart & Lung

Volume 29, Issue 2, March–April 2000, Pages 87-96
Heart & Lung

Issues in Cardiovascular Nursing
Help seeking in a support group for recipients of implantable cardioverter defibrillators and their support persons*

https://doi.org/10.1067/mhl.2000.104138Get rights and content

Abstract

Purpose: To understand shared meanings of help-seeking experiences in support groups of people with implantable cardioverter defibrillator (ICD) and their support persons. Setting: ICD support group at an urban medical center. Sample: Fifteen individuals with ICD and 9 support persons. Results: Six related themes and 1 constitutive pattern emerged. Themes included hearing and telling stories, help seeking encouraged by triggers, seeking meaningful information, forming a therapeutic friendship through group camaraderie, gaining assistance from the facilitator, and the sharing of a similar view by support persons. The constitutive pattern is coping with the possibility of death. Implications: Health care providers may recommend storytelling as the central mechanism of interactions in support groups that assist in coping with daily anxieties of living with an ICD. Nurses would be appropriate facilitators to guide discussion, to provide technical information, and to promote anticipatory guidance in coping with potential firing events. (Heart Lung® 2000;29:87-96.)

Section snippets

REVIEW OF LITERATURE

Literature on life after ICD implantation indicates difficulties in adaptation for patients and their families. The incidence of anger and anxiety is higher in the ICD population than in the general population and other ill populations.3 Patients with an ICD may have severe anxiety that focuses on the fear of future shocks and depression after experiencing ICD shocks.4, 5, 6 Patients with an ICD have identified physical concerns about the sensation of being shocked, medications, and difficulty

BACKGROUND

The institution where the groups are held (a general hospital in an urban area), has been implanting ICDs since 1988. As the population of recipients grew, it became apparent that additional support was needed. The support group was started by a clinical nurse specialist (CNS) in May 1993 to offer guidance and meet the psychosocial needs of individuals with an ICD and the needs of their support persons. Attendance has been consistent and the group continues to be marketed with monthly letters

RESEARCH DESIGN

The method for this study is Heideggerian hermeneutics,21, 22 a phenomenologic approach in which the researchers attempt to uncover the common definitions of “everydayness” in an individual’s life through understanding rather than prediction. To uncover the everyday meanings of help seeking in a support group for recipients of ICDs and their support persons, the researchers sought common themes and constitutive patterns through analysis of focus groups and semistructured interviews. Both

FINDINGS

Over a 9-month period, 5 focus groups and 7 individual interviews were conducted for a total of 24 informants, 15 participants with an ICD and 9 support persons. The groups of people with ICDs included 6 women and 9 men and had a mean age of 65 years with a range of 40 to 76 years. Thirteen had experiences with SCD, 5 had no firings, and of the remaining participants, only 3 had more than 10 firings. The recipients had their ICDs for 0.1 to 7 years, with a mean of 3 and mode of 6. Support

DISCUSSION

Through hermeneutic analysis of the transcripts of the participants with an ICD and their support persons, the value and meaning of help seeking in the support group experience become clearer. Difficulties in coping with SCD and subsequent device implant are documented in the literature and include anxiety, depression, and reduced activity.5, 10, 17 The purpose of this study was to answer the research question, “What is the lived experience of help seeking in a support group for recipients of

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    *

    Reprint requests: Suzanne Steffan Dickerson, DNS, RN, School of Nursing, University of Buffalo, 914 Kimball Tower, 3435 Main St, Buffalo, NY 14214.

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