title: Patients, intimate partners and family experiences of implantable cardioverter defibrillators: qualitative systematic review.
abstract: OBJECTIVE
  This paper is a report of an interpretive review of qualitative research on how an implantable cardioverter defibrillator affects adult recipients and their significant others.
  
  
  BACKGROUND
  An implantable cardioverter defibrillator detects pathological cardiac rhythms and automatically converts the rhythm with electrical counter shocks.
  
  
  METHODS
  A systematic literature search was conducted for qualitative research papers published between January 1999 and January 2009. PubMed, Medline, ISI Web of Knowledge and CINAHL databases were searched with the following key words: internal defibrillator, implantable defibrillator and qualitative research.
  
  
  METHODS
  Twenty-two papers were included. The critical appraisal skills programme and prompts were used to appraise studies. Thematic analysis and synthesis approaches were used to interpret evidence.
  
  
  RESULTS
  People with an implantable cardioverter defibrillator were found to experience physical, psychological and social changes. Shocks produce fear and anxiety, affecting relationships and sexual relations. The use of support groups and the use of the Internet are important in helping adjustment to an implantable cardioverter defibrillator. Women's responses to an implantable cardioverter defibrillator appear different than men's responses and include concerns about physical appearance and relationship issues. Postdischarge follow-up and educational programmes are still underdeveloped.
  
  
  CONCLUSIONS
  Patients need additional education, support and follow-up care after hospital discharge. Patients and significant others benefit from collaboration between patient associations and healthcare professional societies. Future research is needed to identify the specific challenges that women recipients face.
authors: Department of Nursing, Universidad Rey Juan Carlos, Madrid, Spain. domingo.palacios@urjc.es
authors: Domingo
authors: D
authors: Palacios-Ceña
authors: Marta E
authors: ME
authors: Losa-Iglesias
authors: Cristina
authors: C
authors: Alvarez-López
authors: Miguel
authors: M
authors: Cachón-Pérez
authors: Rosalie Ann R
authors: RA
authors: Reyes
authors: Paloma
authors: P
authors: Salvadores-Fuentes
authors: César
authors: C
authors: Fernández-de-Las-Peñas