UCSF

Sudden cardiac death is an unanticipated event, resulting from a cardiac rhythm disturbance. The best option for reducing risk and improving survival in high risk populations is the implantable cardioverter defibrillator (ICD). More individuals are receiving and living with ICDs at advanced ages and for longer periods. Yet, scant research has studied the perspective of individuals who are dealing with the implanted technology while also managing aspects of advancing age in a community setting.

Using qualitative grounded theory methodology, the question of how an ICD affects the daily life of persons living with an ICD was explored. Human subjects¡&hibar; approval was obtained from the sponsoring university¡&hibar;s human subjects committee and approval from the recruitment site was received before the study was started. Twenty-four older adults (¡Ý65) who had lived with an ICD from two to 19 years were recruited from the device clinic of a tertiary care hospital. Data collection consisted of interviews that lasted 30-90 minutes and were conducted with a semi-structured interview guide.

Data collection and analysis occurred in alternating sequences as initially described by Glaser and Strauss (1967) and further informed by Charmaz (2006) and Clark (2005). The researcher transcribed verbatim and then checked transcriptions with audio recordings. Initial open coding examined minute sections of text followed by axial and selective coding in order to determine salient themes and properties that emerged from the data. Data was also collected in the form of analytic and self-reflective memos and positional maps. Theoretical and methodological notes were maintained regarding decisions made during the process.

Study data revealed, the core process of ¡°Living in Partnership¡± that can be characterized by three phases: Entering into a Partnership, Managing the Partnership, and Contemplating or Not Contemplating Dissolving the Partnership. The findings provided insights into the ways older adults come to understand the ICD in the context of their daily lives and serve to inform practitioners involved in their care. Further research focusing on personal meaning and impact is needed to plan for situations along the continuum of living with an ICD and dealing with advancing age.