Characteristics of the Somatic Sensation Experienced by ICD Patients during Pre-Onset and at the Time of Onset

Monday, 7 July 2008: 1:35 PM
Chika Hashimoto, RN, MA , Department of Cardiology, Tokai Universitiy Hospital, Isehara,Kanagawa, Japan
Fumiko Furukawa, PhD, RN , School of Nursing, University of Shizuoka, Shizuoka, Japan
Masami Sato, RN, MA , Department of Nursing, Tokai University School of Health Sciences, Isehara Kanagawa, Japan
Yoshiaki Degucih, MD , Depatment of Cordiology, Tokai University, Isehara Kanagawa, Japan
Kouichirou Yoshioka, PhD, MD , Department of Cardiology, Tokai University, Isehara Kanagawa, Japan

Learning Objective 1: The learner will be able toidentify the characteristics of the sensations that are present before and at the time of onset of ICD.

Learning Objective 2: The learner will be able toshare cultural differences in the expression of the sensations caused by ICD.

There is a lack of information for health professionals dealing with the somatic sensations experienced by patients at the time of implantable cardioverter-defibrillator (ICD) onset. The anticipated sensations created by ICD might enhance patients' fear and anxiety when they are informed that they will receive an ICD. However, few studies have focused on the manner in which patients experience these sensations.

There were two groups of patients: one was recruited from an ICD peer support group, and the other from an outpatient clinic. Thirteen patients gave their written informed consent to participate in this study. The inclusion criteria included ICD onset at least once and no diagnosis of depression. Semi-structured interviews were used to collect the data. The raw data were transcribed; only information related to somatic sensations or feelings was extracted.

Expressions describing the sensations experienced were classified into 186 codes. The codes were grouped based on the sensations' characteristics into three groups: phono-type Japanese expressions, such as “ Doonn”, “Pokon”, “Paann”, “Sutoun”, and “Billi”; descriptive expressions, such as “my back was hit”, “my muscle was cramped”, “my body was pressed”, “my body was abruptly raised”, and “my body was falling down”; and image-type expressions, such as “fire-works from my body”, “electric current running through my body”, and “a tiny bomb exploded”.

The results indicate that the patients experienced uncomfortable somatic sensations that had a greater impact than any previously experienced sensations. The patients always had difficulty finding words to accurately express their sensations. Individual differences also tended to cause various ways of expressing the sensations using words and gestures. To understand the actual sensations that are experienced, common phrases need to be identified from among the various expressions used.