stimulating the patients own ressources, a qualitative study
In and out in 15 minutes! Shorttime nursing in an outpatient clinic Pacemaker patients’ perspective and experiences in a pacemaker outpatient clinic in relation to test intervals of the pacemaker. Background Pacemaker implantation is a highly documented treatment for patients with bradycardia. In Aalborg University Hospital pacemakers are tested when implanted, 3 months later and then two years after the implantation. It is tested by a nurse specialist who also is interested in the patient’s general health status and well being. Patient expectations are unknown. Cheng et al (2002) have found an evident decline in quality of life regarding psychological and social aspects 6 month after the implantation in terms of cognitive function, work ability, and sexual activity. Mlynarski et al (2009) have found correlations between pacemaker implantation and anxiety and depression. Aim The aim of this study was to explore the patients’ experiences during a visit to the outpatient clinic, evaluate on opportunities for personal guidance, and discuss the distribution of the test intervals. Methods Two focus group interviews were conducted with patients (age 34-70) with bradypacemakers. One (3 women, 1 man) before the 3 month visit and one (4 women, 1 man) after the 3 month visit. The interview was transcribed ad verbatim and analyzed inspired by Ricouers three text comprising levels: naïve reading, structural analysis and critical interpretation and discussion. Results Both interviews showed the patients expect the nurses to check the technicalities of the pacemaker and talk about precautions. Long test intervals led to worry that the pacemaker was still working. The patients did not expect specialists to pay attention to psychological reactions as they did not find a correlation between the pacemaker and psychological reactions. Patients with pacemakers older than 3 months lacked communication with fellowmen. Conclusion The patients express receiving competent and professional treatment when visiting the outpatient clinic, there seems to be a discrepancy between the long test intervals and the critical period in which anxiety and depression may occur. Minor problems and questions may grow into fatal conditions if the patients are not offered an opportunity to discuss this with experts. Patients are not informed that it is possible to discuss problems that imply psychological topics and they do not expect receiving guidance concerning these. Implications for practice Patients’ problems might be addressed by either more frequent visits to the outpatient clinic or meetings with fellowmen. Other options to meet with a specialist could be through e-mail, online patient book, YouTube video, and pacemaker rehabilitation.
European Journal of Cardiovascular Nursing, 2014, Vol 13, Issue Suppl. 1