Department of Cardiology, Linköping University Hospital, and Department of Medical and Health Sciences, Division of Nursing Science, Linköping University, Sweden.
J Cardiovasc Nurs. 2010 Nov-Dec;25(6):E1-E10. doi: 10.1097/JCN.0b013e3181e0f881.
The implantable cardioverter defibrillator (ICD) is a lifesaving device for treating patients who have experienced (secondary prevention), or are likely to experience (primary prevention), sudden cardiac death due to ventricular arrhythmias. Individuals with an ICD are prohibited from driving for a restricted period after the implantation and after recurrence of a ventricular arrhythmia, which may affect the ICD recipient in daily life. The aim of this study was therefore to describe how ICD recipients perceive driving and the driving restriction.
Fourteen men and 6 women, aged 43 to 82 years, with driving restrictions due to both secondary and primary ICD indications, were interviewed. Data were analyzed using phenomenography.
The analysis resulted in the main category, the individual's unique relationship to driving, based on the categories: (1) achieving adherence on driving restrictions, (2) emotional influence of driving restriction, and (3) altered views on driving. The information was sometimes conceived as insufficient and unclear, and the willingness to accept the restriction differed. The ICD recipients perceived a loss of independence and changed self-image. Some patients had changed their driving behavior because of uncertainty of their driving abilities or fear of having arrhythmias/shocks while driving. They had different views on their future driving.
Handling driving restrictions after ICD implantation and shocks is a complex and delicate issue in clinical practice and should be addressed in a dialogue with the ICD recipient. More individualized and structured information and support should be given according to the ICD recipients' experiences and needs.
植入式心脏复律除颤器（ICD）是一种救生设备，用于治疗因室性心律失常而经历过（二级预防）或可能经历（一级预防）突然心脏死亡的患者。植入 ICD 后以及室性心律失常复发后，有 ICD 的患者在一段时间内被禁止驾驶，这可能会影响 ICD 接受者的日常生活。因此，本研究旨在描述 ICD 接受者对驾驶和驾驶限制的看法。
对 14 名男性和 6 名女性进行了采访，他们年龄在 43 至 82 岁之间，由于二级和一级 ICD 指征都需要限制驾驶。使用现象学方法对数据进行分析。
分析得出了主要类别，即个人对驾驶的独特关系，基于以下类别：（1）实现对驾驶限制的遵守，（2）驾驶限制的情绪影响，和（3）对驾驶的看法改变。信息有时被认为是不充分和不清楚的，对限制的接受意愿也不同。ICD 接受者认为失去了独立性并改变了自我形象。一些患者因为对自己驾驶能力的不确定性或担心在驾驶时出现心律失常/电击而改变了自己的驾驶行为。他们对未来的驾驶有不同的看法。
在 ICD 植入和电击后处理驾驶限制是临床实践中的一个复杂而微妙的问题，应与 ICD 接受者进行对话。应根据 ICD 接受者的经验和需求提供更个性化和结构化的信息和支持。
