title: Perceptions and experiences of patients living with implantable cardioverter defibrillators: a systematic review and meta-synthesis.
abstract: BACKGROUND
  Sudden cardiac deaths have become a growing major public health concern that affects the world. Despite the various etiologies, life-threatening cardiac arrhythmias attribute the main cause of sudden cardiac deaths. Therefore in certain groups of high-risk patients, the Implantable Cardioverter Defibrillator (ICD) has been recommended as either a secondary or primary prophylactic method of prevention.
  
  
  OBJECTIVE
  To summarise the perceptions of ICD recipients and provide an overview of their experiences with regards to the quality of life, coping strategies, and learning needs.
  
  
  METHODS
  A systematic search was conducted using CINAHL, MEDLINE, PsycINFO, Scopus, Cochrane Library, and Web of Science. Primary research articles published from January 2005 to January 2016 that met the inclusion criteria were selected and assessed for methodological quality.
  
  
  RESULTS
  Thirty-nine articles consisting of 16 qualitative studies, 22 quantitative studies, and 1 mixed methods study were included for the meta-synthesis. Findings extracted from these studies were grouped into eight subthemes with 'living the ICD experience: a constant process of redefining oneself' emerging as an over-arching theme.
  
  
  CONCLUSIONS
  This review provides insight into the perspectives and experiences of ICD recipients. Current evidence highlights the need for healthcare professionals to improve future care standards and develop a patient-centric holistic program that meets the specific needs of ICD recipients. Moreover, future studies are required to address the research gaps identified and also explore the perceptions of patients living with ICD in the Asian context.
authors.affiliation: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore, Singapore.
authors.forename: Sim Leng
authors.initials: SL
authors.lastname: Ooi
authors.affiliation: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore, Singapore.
authors.forename: Hong-Gu
authors.initials: HG
authors.lastname: He
authors.affiliation: Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: Yanhong
authors.initials: Y
authors.lastname: Dong
authors.affiliation: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore, Singapore. nurww@nus.edu.sg.
authors.forename: Wenru
authors.initials: W
authors.lastname: Wang
mesh_terms: D000223:Adaptation, Psychological; D017147:Defibrillators, Implantable / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010465:Perception; D011788:Quality of Life
keywords: Coping strategies; Experiences; Implantable cardioverter defibrillator; Leaning needs; Perceptions; Quality of life; Systematic review