OJN  Vol.4 No.3 , March 2014
Regaining Normalcy in Relatives of Patients with a Pacemaker
Abstract: Patients with chronic diseases, such as those with pacemakers, have shown that they have a worsened well-being, which means an increased interest in investigating how relatives of patients with pacemakers experience their situations and how the disease affects their life situations. The aim of this study was to explore the main concerns for the relatives of patients with a pacemaker and how they resolve these issues. A classic grounded theory was used throughout the study for data collection and analysis. Interviews were conducted with ten participants. Striving for normalcy emerged as the main concern for relatives of patients with a pacemaker and was handled through a process of regaining normalcy where the relatives strive to find a way to live as normal as possible. Regaining normalcy is done through developing trust, dwindling and finally life stabilizing, in which they are either holding back or new normalizing. Distinguishing signs are constantly done during the process to quickly notice possible symptoms of the patient. Increased knowledge and understanding of how the relatives of patients with a pacemaker regain normalcy can be used as a guide in order to support and inform the patient as well as their relatives in conjunction with implantation occasions but also in connection with recurring and lifelong follow-up occasions.
Cite this paper: Malm, D. and Sandgren, A. (2014) Regaining Normalcy in Relatives of Patients with a Pacemaker. Open Journal of Nursing, 4, 139-149. doi: 10.4236/ojn.2014.43018.

[1]   European Society of, C., et al. (2013) ESC Guidelines on Cardiac Pacing and Cardiac Resynchronization Therapy: The Task Force on Cardiac Pacing and Resynchronization Therapy of the European Society of Cardiology (ESC). Developed in Collaboration with the European Heart Rhythm Association (EHRA). Europace, 15, 1070-1118.

[2]   Swedish Council on Health Technology Assessment (SBU). Antibiotikaprofylax Kapitel 6 2011 [cited 2012 12-10] (in swedish).

[3]   Baman, T.S., et al. (2011) Safety of Pacemaker Reuse: A Meta-Analysis with Implications for Underserved Nations. Circulation. Arrhythmia and Electrophysiology, 4, 318-323.

[4]   Karner, A.M., Dahlgren, M.A. and Bergdahl, B. (2004) Rehabilitation after Coronary Heart Disease: Spouses’ Views of Support. Journal of Advanced Nursing, 46, 204-211.

[5]   Lukkarinen, H. and Kyngas, H. (2003) Experiences of the Onset of Coronary Artery Disease in a Spouse. European Journal of Cardiovascular Nursing, 2, 189-194.

[6]   Thomson, P., et al. (2013) Patients’ and Partners’ Health-Related Quality of Life before and 4 Months after Coronary Artery Bypass Grafting Surgery. BMC Nursing, 12, 16.

[7]   Woloshin, S., et al. (1997) Perceived Adequacy of Tangible Social Support and Health Outcomes in Patients with Coronary Artery Disease. The Journal of General Internal Medicine, 12, 613-618.

[8]   Frasure-Smith, N., et al. (2000) Social Support, Depression, and Mortality during the First Year after Myocardial Infarction. Circulation, 101, 1919-1924.

[9]   Malm, D., Karlsson, J.E. and Fridlund, B. (2007) Effects of a Self-Care Program on the Health-Related Quality of Life of Pacemaker Patients: A Nursing Intervention Study. Canadian Journal of Cardiovascular Nursing, 17, 15-26.

[10]   Rassin, M., Zilcha, L. and Gross, D. (2009) “A Pacemaker in My Heart”—Classification of Questions Asked by Pacemaker Patients as a Basis for Intervention. Journal of Clinical Nursing, 18, 56-62.

[11]   Malm, D. and Hallberg, L.R. (2006) Patients’ Experiences of Daily Living with a Pacemaker: A Grounded Theory Study. Journal of Health Psychology, 11, 787-798.

[12]   Malm, D., et al. (2003) Health-Related Quality of Life in Pacemaker Patients: A Single and Multidimensional Self-Rated Health Comparison Study. European Journal of Cardiovascular Nursing, 17, 15-26.

[13]   Beery, T.A., Sommers, M.S. and Hall, J. (2002) Focused Life Stories of Women with Cardiac Pacemakers. West Journal of Nursing Research, 24, 7-23; Discussion 23-7.

[14]   Brannstrom, M., et al. (2007) Being a Close Relative of a Person with Severe, Chronic Heart Failure in Palliative Advanced Home Care—A Comfort but Also a Strain. Scandinavian Journal of Caring Sciences, 21, 338-344.

[15]   Beach, E.K., et al. (1992) The Spouse: A Factor in Recovery after Acute Myocardial Infarction. Heart & Lung, 21, 30-38.

[16]   Timmins, F. and Kaliszer, M. (2003) Information Needs of Myocardial Infarction Patients. European Journal of Cardiovascular Nursing: Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology, 2, 57-65.

[17]   Pihl, E., et al. (2005) Depression and Health-Related Quality of Life in Elderly Patients Suffering from Heart Failure and Their Spouses: A Comparative Study. European Journal of Heart Failure, 7, 583-589.

[18]   Glaser, B. (1998) Doing Grounded Theory: Issues and Discussions. Sociology Press, Mill Valley.

[19]   Glaser, B. (1978) Theoretical Sensitivity: Advances in the Methodology of Grounded Theory. Sociology Press, Mill Valley.

[20]   Glaser, B. (2001) The Grounded Theory Perspective: Conceptualization Contrasted with Description. Sociology Press, Mill Valley.

[21]   Frye, R.L., et al. (2009) Ethical Issues in Cardiovascular Research Involving Humans. Circulation, 120, 2113-2121.

[22]   Nygardh, A., et al. (2011) Empowerment in Outpatient Care for Patients with Chronic Kidney Disease—From the Family Member’s Perspective. BMC Nursing, 10, 21.

[23]   Pihl, E., Fridlund, B. and Martensson, J. (2010) Spouses’ Experiences of Impact on Daily Life Regarding Physical Limitations in the Loved One with Heart Failure: A Phenomenographic Analysis. Canadian Journal of Cardiovascular Nursing, 20, 9-17.

[24]   Karmilovich, S.E. (1994) Burden and Stress Associated with Spousal Caregiving for Individuals with Heart Failure. Progress in Cardiovascular Nursing, 9, 33-38.

[25]   Haley, W.E., et al. (2010) Caregiving Strain and Estimated Risk for Stroke and Coronary Heart Disease among Spouse Caregivers: Differential Effects by Race and Sex. Stroke: A Journal of Cerebral Circulation, 41, 331-336.

[26]   Hooyman, N.R. and Gonyea, J.G. (1999) A Feminist Model of Family Care: Practice and Policy Directions. Journal of Women & Aging, 11, 149-169.

[27]   Flemme, I., et al. (2011) Uncertainty Is a Major Concern for Patients with Implantable Cardioverter Defibrillators. Heart & Lung, 40, 420-428.

[28]   Kamphuis, H.C., et al. (2004) ICD: A Qualitative Study of Patient Experience the First Year after Implantation. Journal of Clinical Nursing, 13, 1008-1016.

[29]   Paul, F. and Rattray, J. (2008) Short- and Long-Term Impact of Critical Illness on Relatives: Literature Review. Journal of Advanced Nursing, 62, 276-292.

[30]   Crowe, A. (2011) The Social Media Manifesto: A Comprehensive Review of the Impact of Social Media on Emergency Management. Journal of Business Continuity & Emergency Planning, 5, 409-420.

[31]   Martensson, J., Dracup, K. and Fridlund, B. (2001) Decisive Situations Influencing Spouses’ Support of Patients with Heart Failure: A Critical Incident Technique Analysis. Heart & Lung, 30, 341-350.

[32]   Dassen, W.R., et al. (1999) The Impact of the Millennium Problem on Implantable Pacemakers and Defibrillators. Pacing and Clinical Electrophysiology: PACE, 22, 517-520.

[33]   Carranza, N., et al. (2011) Patient Safety and Electromagnetic Protection: A Review. Health Physics, 100, 530-541.

[34]   Ismail, M.M., et al. (2010) Third-Generation Mobile Phones (UMTS) Do Not Interfere with Permanent Implanted Pacemakers. Pacing and Clinical Electrophysiology: PACE, 33, 860-864.

[35]   Tiikkaja, M., et al. (2012) Electromagnetic Interference with Cardiac Pacemakers and Implantable Cardioverter-Defibrillators from Low-Frequency Electromagnetic Fields. Europace, 15, 388-394.

[36]   Hayes, D.L., Wang, P.J., Reynolds, D.W., Mark Estes, N.A., Griffith, J.L., Steffens, R.A., Carlo, G.L., Findlay, G.K. and Johnson, C.M. (1997) Interference with Cardiac Pacemakers by Cellular Telephones. The New England Journal of Medicine, 336, 1473-1479.

[37]   Jussila, A.L. (2008) Stabilising of Life: A Substantive Theory. The Grounded Theory Review, 7, 29-41.

[38]   Birkeland, A.L., Rydberg, A. and Hagglof, B. (2005) The Complexity of the Psychosocial Situation in Children and Adolescents with Heart Disease. Acta Paediatrica, 94, 1495-1501.

[39]   Coyne, J.C. and Smith, D.A. (1991) Couples Coping with a Myocardial Infarction: A Contextual Perspective on Wives’ Distress. Journal of Personality and Social Psychology, 61, 404-412.

[40]   Coleman, C.I., Coleman, S.M., Vanderpoel, J., Nelson, W., Colby, J.A., Scholle, J.M. and Kluger, J. (2012) Factors Associated with ‘Caregiver Burden’ for Atrial Fibrillation Patients. International Journal of Clinical Practice, 66, 984-990.

[41]   Sandgren, A., Thulesius, H. and Petersson, K. (2010) Living on Hold in Palliative Cancer Care. The Grounded Theory Review, 9, 79-100.

[42]   Bergbom, I. and Askwall, A. (2000) The Nearest and Dearest: A Lifeline for ICU Patients. Intensive & Critical Care Nursing: The Official Journal of the British Association of Critical Care Nurses, 16, 384-395.

[43]   Tidenman, M. (2000) Normalization and Categorization-On Disability Ideology and Welfare Policy in Theory and Practice for Intellectually Disabled Persons. In: Tidenman, M., Ed., Student litteratur AB, Lund.

[44]   Konlaan, B.B., Bygren, L.O. and Johansson, S.E. (2000) Visiting the Cinema, Concerts, Museums or Art Exhibitions as Determinant of Survival: A Swedish Fourteen-Year Cohort Follow-Up. Scandinavian Journal of Public Health, 28, 174-178.

[45]   Baigi, A., Hildingh, C., Virdhall, H. and Fridlund, B. (2008) Sense of Coherence as Well as Social Support and Network as Perceived by Patients with a Suspected or Manifest Myocardial Infarction: A Short-Term Follow-Up Study. Clinical Rehabilitation, 22, 646-652.