Life after ICD implantation : living with uncertainty

This article includes three sections relating to the conduct of a piece of research, which aimed to add to the theoretical understanding of psychological distress in ICD (implantable cardioverter defibrillator) recipients. Literature review: The research literature and theories relating to psychological distress in ICD recipients is reviewed. Findings reveal that research in this area is limited, and compromised by significant methodological limitations. Theories advanced to explain psychological distress in ICD recipients are under-developed and lack robustness. Research Report: This report interviews ICD recipients four months after device implantation. None of the participants had received appropriate shock therapy from the device. Their accounts were analysed using a grounded theory method. A core category was identified and termed 'uncertainty and ambiguity'. This highlight the uncertainty that recipients experience in relation to their health. It also refers to the uncertainty as to whether the device represents a 'threat or security', and whether it subsequently signifies a 'second chance or limited life'. Therapeutic interventions are indicated that might address 'threat' and uncertainty, so reducing anxiety and allowing individuals to continue to engage with life in a fulfilling way. Such engagement is crucial to prevent depression and maintain general self-efficacy in ICD recipients. Critical Appraisal: Reflections relating to the conduct of this piece of research are outlined. These include the importance of effective alliances, balancing comprehensive data collection with respect for the interviewee, and the role of supervision and self-reflection in ensuring quality research.