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  • 學位論文

裝置植入性心律整流去顫器病人的身體活動經驗

The Experience of Physical Activity in Patient with Implantable Cardioverter Defibrillator

指導教授 : 鄭綺

摘要


本研究以質性研究的內容分析法為研究方法,研究的目的在深入了解裝置植入性心律整流去顫器(Implantable Cardioverter Defibrillator, ICD)病人的身體活動經驗。採立意取樣共收集了14位年齡介於28-65歲初次裝置ICD的病人,以深入訪談的方式收集個案的訪談資料,以了解其接受心律整流去顫器植入後,身體活動上的經驗感受。資料分析採持續比較法反覆的驗證及收集資料,一直到沒有新的分析類屬出現,亦就是資料呈現「飽和」。 研究結果:分析出4個主要主題12個類屬,分別為(一)裝ICD前之經驗,包含:感受到生命威脅及接受治療的背景經驗二個類屬;(二)電擊經驗及感受,包含:電擊前的身體感覺、電擊時的身體感受、電擊後的心理衝擊;(三)裝ICD後身體活動的衝擊,包含:日常活動受限、因擔心而自我限制活動;(四)力求與ICD共存、調整再出發,包含:感受裝置ICD的意義、調整活動項目或強度、減少電擊發生的自我調節、尋求生活獨立、接受限制、走向慢活人生。 本研究發現病人在植入ICD後,身體活動及整體生活上受到許多的影響,電擊的發生更加深了影響程度,透過本研究的結果可以提供臨床上醫護人員深入了解裝置ICD後的病人在身體活動及生活上的經驗,以提供臨床護理實務、護理教育及未來研究之參考。

並列摘要


Implantable cardioverter defibrillator (ICD) has been used to reduce mortality in patients at risk of sudden cardiac death for decades. Although that, the experiences of physical activity are unknown. The purpose of this study was to describe the experiences of physical activities in patient with implantable cardioverter defibrillator (ICD). The qualitative study design was used to explore the experiences of physical activity of 14 adults with ICD using face-to-face, semi-structured interviews. Transcripts were analyzed using the method of constant comparison. Fourteen patients with ICD (5 women, 9 men) between the ages of 28 to 65 years(mean 46.6 year s). Four themes and 12 categories were identified: (1)the experiences before ICD implantation, included: feeling of lives threatening, the background of taking action for receiving treatment; (2)the experiences and feeling of ICD shock, included: physiological signs and symptoms before ICD shock, bodily feelings during ICD shock and psychological impacts post ICD shock; (3)the impacts of physical activity after ICD implantation, include: Daily active barriers, self concern induces limitation of leisure activities; (4)living with ICD., include: feel the meaning of ICD, adjust the intensity and project of activities, self-care of reducing the ICD shock, seeking independent, accepting the limitations and restructuring. Implantable cardioverter defibrillator recipients face a complex situation in many ways, the impacts of physical activities are rare proposed, these finding provide the clinical practices are able to explain to future patients what they can expect after ICD implantation. The predictors of ICD shock need to be researched further and the exercise prescription of patient with ICD should be established.

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