Department of Medicine and Health Sciences, Division of Nursing Science, Linköping University, Linköping, Sweden.
J Clin Nurs. 2011 Sep;20(17-18):2600-8. doi: 10.1111/j.1365-2702.2010.03540.x. Epub 2010 Oct 21.
To describe the clinical aspects of implantable cardioverter defibrillators care in Sweden with focus on organisation, the role and education of nurses, patient information and education and areas in need of improvement.
Implantable cardioverter defibrillators implantations have developed rapidly in recent years and are now an established arrhythmia treatment. The expanding indication for implantable cardioverter defibrillators implantation demands new competencies and resources in the implantable cardioverter defibrillators team members.
Participants were recruited among physicians and nurses in all of the hospitals implanting implantable cardioverter defibrillators (n = 16). Data were collected by a questionnaire. Additionally, all written educational materials provided to patients pre- and postimplant were collected from all 16 hospitals. Deductive content analysis using Sarvimäki and Stenbock-Hult's five holistic dimensions was employed to ascertain how information was provided in brochures and information materials.
Half of the hospitals (n=8) had nurse-based outpatient clinics and several others planned to introduce them. Three hospitals carried out distance follow-ups by means of tele-monitoring. The nurses had received specific implantable cardioverter defibrillators education from implantable cardioverter defibrillators companies and/or various university courses. The biophysical dimension dominated in the information material, while the emotional, intellectual and socio-cultural dimensions were scarcely described, and the spiritual-existential was not referred to at all.
Holistic care of implantable cardioverter defibrillators patients can be achieved by means of a multidisciplinary implantable cardioverter defibrillators team and more patient-centred educational strategies. In Sweden, the organisation of implantable cardioverter defibrillators care and follow-up is developing towards more nurse-based clinics.
Development and implementation of structured care programmes with a more holistic approach can improve future implantable cardioverter defibrillators care. The content of the written educational materials need to be more holistic, rather than mainly focusing on the biophysical and technical aspects of living with an implantable cardioverter defibrillators.
描述瑞典植入式心脏复律除颤器护理的临床方面，重点介绍组织、护士的角色和教育、患者信息和教育以及需要改进的领域。
近年来，植入式心脏复律除颤器的植入发展迅速，现已成为一种成熟的心律失常治疗方法。植入式心脏复律除颤器植入的扩展适应症需要在植入式心脏复律除颤器团队成员中具备新的能力和资源。
在所有植入植入式心脏复律除颤器的医院中，招募医生和护士作为参与者（n=16）。通过问卷调查收集数据。此外，从所有 16 家医院收集了所有植入前和植入后的患者书面教育材料。采用 Sarvimäki 和 Stenbock-Hult 的五个整体维度的演绎内容分析，以确定小册子和信息材料中提供信息的方式。
一半的医院（n=8）设有以护士为基础的门诊诊所，其他几家医院计划引入这种诊所。三家医院通过远程监测进行远程随访。护士接受了来自植入式心脏复律除颤器公司和/或各种大学课程的特定植入式心脏复律除颤器教育。信息材料主要以生物物理维度为主，而情感、智力和社会文化维度描述较少，精神-存在维度则完全没有涉及。
通过多学科植入式心脏复律除颤器团队和更以患者为中心的教育策略，可以实现对植入式心脏复律除颤器患者的全面护理。在瑞典，植入式心脏复律除颤器护理和随访的组织正在朝着以护士为基础的诊所发展。
通过更全面的方法制定和实施结构化的护理计划，可以改善未来的植入式心脏复律除颤器护理。书面教育材料的内容需要更加全面，而不仅仅是主要关注植入式心脏复律除颤器的生物物理和技术方面。
