A Descriptive Study to Assess the Level of Anxiety
among Patients with Cardiac Pace Maker
Mr.
Vardaman Samaje
Assistant Professor, Dr. J. J. Magdum
Institute of Nursing, Jaysingpur. Kolhapur, Maharashtra.
*Corresponding Author Email: vbsamaje@gmail.com
ABSTRACT:
Background of
study :Anxiety following a major
cardiac event can impede recovery and is associated with a higher morbidity and
mortality. A growing body of evidence now suggests that there is presence of
negative affective state like anxiety. Patients experience anxiety due to
unusual special procedures like implantation of artificial pacemaker. Patients
usually worry and anxious about pacemaker function, possible complications and
adjustment following the procedure. To provide comprehensive care, nurse has to
assess the anxiety among patients with implanted cardiac pacemaker. Hence this
study has been conducted to assess the level of anxiety among patients with
cardiac pacemaker in selected cardiac institutions Bengaluru,
with a view to develop an information guide sheet on coping strategies. Objectives of study :To assess the level of anxiety among patients
with cardiac pace maker and to find the association between the level of anxiety
among patients with cardiac pace maker with selected socio-demographic variables.
To develop and provide an information guide sheet on coping strategies. Methods
:The study involved non experimental approach, and descriptive research
design with purposive sampling technique. To collect the data from respondents,
structured interview schedule was used and administered to 60 artificial
cardiac pacemaker implanted patients following inclusion and exclusion criteria.
The tool consisted 45 items regarding assessment of anxiety. The validity and
reliability (0.834) of tool was obtained to conduct the study. The results were
described by using descriptive and inferential statistics. Results of study: The study explores out of 60 respondents 16
had no anxiety and 44 respondents had mild anxiety and no respondents had
moderate and above level of anxiety. The highest mean anxiety regarding
artificial pacemaker implantation was 44.4% found in the economical
aspect and followed by psychological aspect mean anxiety was 39.2%. Social
aspect mean anxiety was 36.3%. Family aspect mean anxiety was 32.5 % .Physical and
physiological aspect wise mean anxiety was 28.3%. The overall mean anxiety of respondents was 34.6% with
SD 10.3%.Data was been subjected to chi square to find association. There are significant
associations were found between anxiety level of respondents and demographic
variables such as age (8.55*), type of family (6.16*), type of pacemaker (6.51*) and other illness
identified (6.09*) at 0.05 level.
Interpretation and Conclusion: The overall findings of the study clearly
showed that there is presence of mild anxiety among patients with cardiac
pacemaker. And study significantly explores and describes the need for
assessment of anxiety to provide physical and psychological integrated care to
prevent anxiety and to develop appropriate coping strategies.
KEYWORDS:. Assess,
Anxiety, Cardiac Pace maker, Patient with Cardiac Pacemaker.
INTRODUCTION:
Anxiety is a psychological
and physiological
state characterized by somatic, emotional,
cognitive
and behavioral
components. The root meaning of the word
anxiety is ‘to vex or trouble’ in either presence or
absence of psychological stress, anxiety can create feelings of fear, worry,
uneasiness, and dread. Anxiety is considered to be a normal reaction to a stressor. It may help an individual to deal with
a demanding situation by prompting them to cope with it. When anxiety becomes
excessive, it may fall under the classification of an anxiety disorder.1 Anxiety is consider being
common and evident among cardiac disorders patients, mainly who needs acute
medical and surgical procedures to recover. And anxiety should be assessed
along with physiological condition. Person who faces special cardiac procedure
like cardiac pacemaker implantations are more prone to become anxious or panic,
and can worsen the symptoms or diseases from which person is suffering.5
Whereas heart is a vital organ in human body, it is
hollow muscular organ and pumps blood to meet the metabolic needs of our body.
To pump blood effectively it needs synchronized effort of stimulation in the
heart to coordinate cardiac output, and it is naturally done by two pace makers
of heart named sinoatrial node and atrioventricular node. When there is problem associated
with these two pace makers patient suffers from cardiac rate and rhythm
problems like bradycardia, dysrhythmias
and arrhythmias2 and patients
will develop signs and symptoms like syncope, fatigue, dysrhythmiasis,
palpitation, and bradycardia, shortness of breath,
low blood pressure and anxiety. When medications are not effective to treat
underlying problem, then there is need of artificial cardiac pace maker to
bring the heart to normal rate and rhythm.3
NEED
FOR THE STUDY:
Anxiety is an emotional response to anticipation of
danger i.e. apprehension, tension, uneasiness, the source of which is largely
unknown or unrecognized. Anxiety may be regarded as pathological when it
interferes with effectiveness in living, achievement of desired goals or
satisfaction, or reasonable emotional comfort. For many years anxiety is viewed
as psychological or biological in nature. Many Researchers have began to focus
on the interrelatedness of mind and body, anxiety disorders provides an
excellent example of this relationship.6
The prevalence of anxiety disorder
among cardiac patients in medical setting found to be, panic disorder
with agoraphobia 5.4%, agoraphobia 6.3%, generalized anxiety disorder 8.5%,
specific phobias 4%, any anxiety disorder 30.8%.7 Each year for different cardiac diseases pacemaker
therapy is performed in the range of 88 to a maximum of around 1200/ million
inhabitants, that is 3,00,000 patients worldwide. Regarding
a potentially different medical consensus in specific countries the use of
biventricular pacemakers vs. biventricular ICDs shows 8:1 ratio at the highest down to 1:1.2 ratio
as the lowest. Each year some 20,000 patients of arrhythmia or irregular
heart beat patients are admitting for a pacemaker therapy in the India,
untouched by the economic recession, in the year 2008. So pace maker therapy is
life saving in patients with dysrhythmiasis of heart.
Pace maker can be implanted for 15 years with average of 5 to 12years.8
Nurses caring for such a
patient, ensuring pacer capture and wound healing is not enough. Essential assessment must include
psychological adaptation and body image in order to try and avert future
problems such as anxiety, depression and anger.
These patients may report anxiety at being dependent on a machine,
concern over scarring, and reluctance to resume typical activities that would
not interfere with the device. Patients especially those receiving a permanent
pace maker, should be assessed for anxiety. In addition for those receiving
permanent pace makers, the level of knowledge and
learning needs of the family and the history of adherence to the therapeutic
regimen should be identified.9
Statement
of the problem:
“A study to assess the
level of anxiety among patients
with cardiac pace maker in selected cardiac institutions Bengaluru, with a view to develop an information guide sheet
on coping strategies”.
Objectives of study:
1. To assess the level of anxiety among patients
with cardiac pace maker.
2. To find the association between the level
of anxiety among patients with cardiac pace maker with their selected
socio-demographic variables.
3. To develop and provide an information guide
sheet on coping strategies.
Assumptions:
1. The patients may have anxiety regarding
pace maker work and its complications.
2. Information guide sheet may help to use
appropriate coping strategies of anxious patients with cardiac pace maker.
Variables:
It includes all demographic variables such as age,
sex, marital status, family income, occupation, educational status, religion,
type of family, type of pacemaker, source of information, duration completion
after implantation, substance intake, illness identified, duration of present
illness, relaxation therapy followed.
Operational Definitions:
a) Assess:
It is to measure the anxiety among cardiac
pace maker patients.
b) Anxiety:
Refers to patients feeling of apprehension
and agitated response to cardiac pace maker.
c) Patients:
These are the persons male or female have
got implanted cardiac pace maker.
d) Cardiac
pace maker:
These are the temporary or permanent cardiac implants
works as artificial pace maker.
e) Information
guide sheet:
It is a written material containing
information regarding coping strategies on anxiety with cardiac pace maker.
f) Coping
strategies:
These are the appropriate techniques used
by patients to overcome anxiety with cardiac pace maker.
Research
Approach:
The selection of research approach is the
basic procedure for the research of
enquiry. The research approach helps the researcher to determine the data to collect
and analyze. It also suggests possible conclusions to be drawn from the data.
In view of the nature of the problem selected, the present study is to assess
the level of anxiety among patients with cardiac pacemaker with a view to
develop an information guide sheet on coping strategies. A non experimental approach was considered appropriate in order to accomplish the objectives.
Research
Design:
Pilot and Hungler
(1999) stated that, research design incorporates the most important methodology
decisions that a researcher makes in conducting a research study. It depicts
the overall plan for organization of scientific investigation. Descriptive
research design was used to assess the level of anxiety among patients with
cardiac pacemaker with a view to develop an information guide sheet on coping
strategies.
Variables
under Study:
Attribute variables (AV):
Personal characteristics which include Age, Sex,
Religion, Marital status, Educational qualification, Type of family,
Occupation, Family Income, Type of Pacemaker, Substance use, Duration of
Completion, Source of information, Illness identified, Duration of present illness, Relaxation therapy followed.
Setting of the Study:
The study was conducted in the Hospital Shri Jayadeva institute of
cardiovascular sciences and research hospital, Bengaluru.
Familiarity with the setting and availability of the required samples were also
considered while selecting the study group.
a. Population:
The target population of the study was implanted
artificial cardiac pacemaker patients. Accessible population was patients
implanted with artificial pacemaker in Shri Jayadeva institute of cardiovascular and research hospital,
Bengaluru.
b. Sample and Sampling Technique:
The sample consists of a population selected to
participate in a research study. In the study, a purposive sampling method
through non-probability sampling approach was used for selection of subjects.
c. Criteria for Selection of the Sample:
a) Inclusion criteria:
1. Patients with age 30 years and above.2. Patients
who are present at the time of data collection
3. Patients who are willing to participate in the
study.
b) Exclusion criteria:
1. Patients
below the age of 30 years.
2. Patients who
are sick and critically ill.
Selection and Development of
Tool:
A structured interview schedule was selected for the
study. It was considered to be the most appropriate instrument to elicit the
response from subjects who are not able to read Kannada / English.
Development of the Tool
A
structured interview schedule was prepared to assess the level of anxiety among
implanted cardiac pacemaker patients. The steps carried out in preparing the
tools are:
· Literature review an Preparation of blue
print and then Establishment of validity and reliability.
a. Review of Literature:
Review of literature from books, journals, published
and unpublished research studies were reviewed and used to develop the tool.
b.
Description of the Tool:
In the present study the
following tool was used.
Part-I:
Consisted of 15 items related to socio-demographic
data of the subjects.
Part-II:
Structured interview schedule consisted of 45 items
for assessment of level of anxiety regarding implanted cardiac pacemaker. Scale
subdivided under five aspects. Each item of the scale has 4 scores ranging from
0 to 3. And 0 score indicates ‘no anxiety’ (never), 1 score is for ‘rarely’ and
2 score is for ‘often’, 3 score for ‘all the time’ anxiety is present.
Section-A:
Consisted of 17 (37.77%) items regarding physical and
physiological aspect about implanted pace maker patients.
Section-B:
Consists of 17 (37.77%) items regarding psychological
aspect of pacemaker implanted patients.
Section-C:
Consists of 4 (8.88%) items regarding social aspect of
pacemaker implanted patients.
Section-D:
Consists of 4 (8.88%) items regarding family aspect of
pacemaker implanted patients.
Section E:
Consist of 3(6.66%) items regarding economical aspect
of pacemaker implanted patients.
Measuring level of anxiety:
§ If the scale scores more than 75% means
severe anxiety.
§ It scores between 50 – 74 % moderate
anxiety.
§ It scores between 25 – 49 % indicates mild
anxiety.
§ It scores < 25 % means no anxiety.
c. Content Validity of the Tool:
The prepared blue print of the tool along
with objectives of the study was submitted to the experts for content validity.
Twelve experts from the Nursing faculty and one Doctor and Statistician
validated the tool content. The suggestions given by them were incorporated and
the tool was modified. The final tool got its shape after modification based on
the opinions of the guide and co-guide. It consisted of 15 items regarding
socio-demographic data and to assess anxiety 45 items were included, which had
100% agreement
d. Reliability of the Tool:
The tool, after validation was subjected to test for
its reliability. The structured interview schedule was administered to 6
samples. The reliability of the tool is computed by using split half Karl
Pearson’s correlation formula (raw score method). The reliability of Split Half
test was found by using Karl Pearson correlation by deviation method. Spearman
Brown’s Prophecy formula was used to find out the reliability of the full test.
The reliability co-efficient on level of anxiety found to be 0. 9524 and
revealing the tool is feasible for administration for the main study. Since the
level of anxiety reliability co-efficient for scale r > 0.70. The tool was found to be reliable and feasible.
RESULTS:
Section1:
Demographic variables of respondents classification of respondents by age and
sex:
In the study respondents belong to the age
group of 41-50 years were 19 (31.7%) and followed by respondents within 51-60 years
of age group were 18 (30.0%). And within 61-70 years age group respondents were
14 in number (23.3%). And 71-80 years were least 9(15%) in number. The study explores
that Male respondents were more in number as compared with female respondents.
Male respondents were 41 (68.3%) in number and female respondents were 19
(31.7%).
Fig
1. Demographic variables of respondents classification of respondents by age
and sex
Classification of respondents
by marital status and educational level :
The study reveals that
majority of respondents 49 were married and constitute 81.7% of whole.
Separated respondents were 11 in numbers constitute 18.3% of total. Majority of
respondents were educated PUC and above and they were 37 in number constitutes
61.7% of whole. Followed by middle school educated were 12 (20%). And high
school educated were 6 (10%). And primary education completed respondents were
5 in number constitutes 8.3%.
Fig. 2. Classification
of respondents by marital status and educational level
Classification
of respondents by occupational status and substance use :
In regarding occupational
status the majority of respondents were 22(36.7%) self employed. And followed
by private job holders were 8 (30%). Government employees were 14 (23.3%) in
number. And others employees were 6(10%) in number. The study explores that the
majority of respondents were not habited to any substances use were 40 in
number, constitutes 66.7% of whole. And followed by consumer of alcohol were 12
in numbers constitute 20%, and smokers were 8 in number and constitute 13.3%.
Fig.
3 Classification
of respondents by occupational status and substance use
Classification of respondents
by source of information :
Regarding source of
information about cardiac pacemaker, 15 (25%) respondents were acquired
information through television, 15 (25%) persons from hospital health
information. News papers based information was gained by 15 (25%) respondents.
And information through friends / colleagues were 8 (13.3%) and from print
media 7 (11.7%) were acquired information.
Fig. 4 Classification of
respondents by source of information
Classification of respondents
by religion and family income /month:
The study finds that majority
of respondents belongs to Hindu religion were 27 (45%) and followed by
Christians were 12 (20%). Respondents belong to other religions were 11 in
number (18.3%) and Muslims were 10 in number (16.7%).The study finds that in
respect to family income, majority of respondents were having their monthly
income between 5,001-8,000 Rs were 23(38.3%). Followed by respondents 20
(33.3%) were having monthly income 2,001-5,000 Rs. Monthly income 8001- 11000
Rs respondents were 17 (28.4%) in number.
Fig.
5. Classification of respondents by religion and family income /month
Classification of respondents
by type of family and type of pacemaker :
The data from study reveals majority of respondents were
belongs to joint family were 37 in
number and constitutes 61.7% of whole and
remaining belongs to nuclear family
they were 23 in number
constitutes 38.3%.The study explores
that in regards to type of pacemaker the majority of respondents having
temporary pace maker implantation were 41 (68.3 %). Permanent pacemaker
implanted patients were 19 (31.7%) in number.
Fig. 6 Classification of
respondents by type of family and type of pacemaker
Classification
of respondents by completion of duration after implantation and duration of
present illness :
The study depicts that
majority of respondents completed duration of 7 days after implantation were 30
(50%). Who crossed duration 1 month were 12(20%) in number. Respondents
duration within 8 -14 days were 11(18.3%) in number. 1 month duration completed
were 7(11.7%).Study explores that respondents Duration of present illness
revealed majority of persons having present illness within 1 - 3 months were 27
(45%). Present illness within 4- 6 months and more than a year respondents were
same in number 13(21.7%). And present illness within 7-12 months respondents
were 7(11.7%).
Fig. 7 Classification of respondents by completion of
duration after implantation and duration of present illness
Classification
of respondents by other illness identified and following relaxation therapy:
The majority of respondents
41(68.3%) were not having any other illness.
Followed by hypertensive respondents were 13 (21.7%) and diabetes
mellitus sufferers were 6 (10%) in number. The majority of respondents 38
(63.4%) were not following any relaxation therapy. Followed by respondent
practising yoga were17(28.3%) in number. Medications users were 3 (5%) in
number. And respondents who practice meditation were 2(3.3%) in number.
Fig.
8 Classification
of respondents by other illness identified and following relaxation therapy
Section-2: Anxiety level of
respondents on cardiac pacemaker:
Classification of respondents
on anxiety level on cardiac pace maker :
Many patients get treated with artificial cardiac
pacemaker and presence of anxiety among those implanted with cardiac pacemaker
should be identified for its prevention and proper care. And in present study
60 subjects were used and it is found in the study that majority of patients
suffers with mild anxiety as compared to no anxiety. The 60 respondents data when subjected to statistical analysis
level of anxiety reveals that, majority of 44 persons suffers with mild anxiety
constitute 73.3% of whole. And remaining respondents 16 with no anxiety
constitute 26.7%. And there is no
respondent experienced moderate and above level of anxiety. And study finds
that out of 60 subjects implanted with cardiac pacemaker among ample
of them had mild anxiety and rest other had no anxiety.
Fig.
9 Classification of respondents on anxiety level on cardiac pace maker
Section 3: Aspect wise anxiety level of respondents on
cardiac pace maker Aspect wise anxiety of respondents
Table
1.
|
No. |
Anxiety Aspects |
Statements |
Max. Score |
Respondents Anxiety |
|||
|
Mean |
SD |
Mean(%) |
SD(%) |
||||
|
I |
Physical & Physiological |
17 |
51 |
14.43 |
8.3 |
28.3 |
16.2 |
|
II |
Psychological |
17 |
51 |
19.98 |
8.3 |
39.2 |
16.3 |
|
III |
Social |
4 |
12 |
4.35 |
2.0 |
36.3 |
16.6 |
|
IV |
Family |
4 |
12 |
3.90 |
2.5 |
32.5 |
20.9 |
|
V |
Economical |
3 |
9 |
4.00 |
2.9 |
44.4 |
32.7 |
|
|
Combined |
45 |
135 |
46.67 |
13.9 |
34.6 |
10.3 |
The collected data when
computed for aspect wise anxiety scores of respondents, the following results
were depicted. The total anxiety of respondents was been assessment under 5
aspects they were as follows physical and physiological, psychological, social,
family and economical. And results of respondents aspect wise mean anxiety is
depicted in descending order as found among respondents is as follows, in
economical aspect mean anxiety was highest 44.4%. And followed by psychological
aspect mean anxiety was 39.2% and social aspect mean anxiety was found to be
36.3%. And family aspect mean anxiety
was 32.5%. Physical and physiological aspect mean anxiety was found to be
28.3%. And combined mean anxiety was 34.6% with standard deviation of 10.3%.
Fig.
10 Aspect wise anxiety level of
respondents on cardiac pace maker Aspect wise anxiety of respondents
Section 4: Association
between demographic variables and anxiety level on cardiac pace maker patients
The demographic variables
analyzed in this study were age, sex, religion, marital status, monthly income,
education status, types of family, and types of pace maker, duration of completion after implantation
,source of information ,duration of illness, other illness identified,
substance use, following any relaxation therapy. The association between the
demographic variables and level of anxiety scores was computed by using X2 test at 0.05 (5% level) and
different levels of degrees of freedom are used. And significant associations
are found are found in study age group (8.55*), type of family
(6.16*), type of pacemaker (6.51*), other illness
identified (6.09*). Remaining demographic variable had no
significant association with level of anxiety among patients with cardiac
pacemaker.
In the study respondents
belongs to the age group of 41-50 years were
19 (31.7%), among 9 respondents had no
anxiety (47.4%) and 10 members had mild anxiety (52.6%). Followed by 51-60
years age group respondents were 18 in number (30.0%) in that 5 members had no
anxiety (27.8%), 13 members had mild anxiety 72.2% . And 61-70 years clients were
14 in number(23.3%) in that 2 had no anxiety ( 14.3%) and 12 had mild anxiety (
87.5% ). And 71-80 years were scanty in number 9(15%) and in this age group all had
mild anxiety (100%) regarding implanted pace maker. The obtained chi-square
value was found to be 8.55*
which is higher than table value at 5 percent level of significance. Hence,
there is a significant association between Age group and anxiety level of
respondents.
The data from study reveals majority of respondents 37 were
belongs to joint family and constitutes the
61.7% of whole, among 14 had no
anxiety (37.8%) and 23 had mild anxiety (62.2%) . And remaining belongs to
nuclear family they were 23 in number constitutes 38.3% among them 2 had no anxiety (8.7%) and
21 members had mild anxiety (91.3%).The obtained chi-square value was found to
be 6.16* which is higher than table value at 5 per cent level of
significance. Hence, there is a significant association between type of family
and anxiety level of respondents.
The study explores that the
majority of respondents were having temporary pace maker insertion they were 41
(68.3 %) in number among one had no
anxiety (5.3%) and rest other 18 had mild anxiety (94.7%). And permanent
pacemaker implanted patients were 19(31.7%) in number among them 15 had no
anxiety (36.6%) and 26 had mild anxiety (63.4%). The obtained chi-square value was found to be 6.51*
which is higher than table value at 5 per cent level of significance. Hence,
there is a significant association between type of pacemaker and anxiety level
of respondents.
The majority of respondents 41
(68.3%) were not having any other illness among them 7 had no anxiety (17.1%)
and 34 persons had mild anxiety (82.9%). And followed by hypertensive and diabetes
mellitus patients were 19 in numbers among 9 had no anxiety (47.4%) and 10
respondents had mild anxiety (52.6%). The obtained chi-square value was found to be 6.09* which is
higher than table value at 5 per cent level of significance. Hence, there is a
significant association between illness identified and anxiety level of
respondents.
Major
Findings related to demographic variables:
Regarding
age majority of respondents 19 (31%) were in 41-50 years of age group, 41(68.3%) were
males, 37(61.7%) members were from joint family, 49(81.7%) were married. Hindu were
27(45.%). 37
(61.7%) of the respondents had studied PUC and above . 22 (36.7%) were self
employed. 23 (38.4%) were having income within
5,001 – 8,000 rupees per month .Regarding source of information television,
hospital health information, news papers utilizers
were same15 (25%) in num, 41 (68.3%) were implanted with temporary pacemaker,
30 (50%) were within 1 – 7 days of Duration after implantation,27(45%) were
having Duration of present illness within 1-3 months, 41 (68.3%) were not
having any other illness. 40 (66.7%) were not having any habits of substance
use. 38 (63.4%) were not following any relaxation therapy.
Major findings related to anxiety:
The highest mean
anxiety was 44.4% found
in the economical
aspect regarding pace maker implantation. And second highest mean anxiety was
39.2% found in psychological aspect. Then followed by social aspect mean
anxiety was 36.3%.Family
aspect mean anxiety was 32.5 %.Physical and physiological aspect mean anxiety
was 28.3%.The
overall mean anxiety of respondents was 34.6% with SD 10.3%.
Major findings related to association between
demographic variables and anxiety level among patients with cardiac pacemaker:
There is a significant
associations were found between anxiety level of respondents and their age (8.55*), type of family (6.16*), type of pacemaker (6.51*) & other illness (6.09*). There is a
non-significant associations between anxiety level of respondents and sex (0.45NS), marital status
(2.13NS),their
religion (2.05NS), education (0.27NS), occupational
status (3.76NS), family income / month (2.82NS), substance use (1.11ns), source of information (2.54NS), duration after
implantation (0.61NS), duration of present illness (1.57ns), following relaxation
therapy (3.82ns).
CONCLUSION:
The overall mean and mean
percentage of anxiety was calculated and it was found to be 34.6 % with SD
10.3%. Results revealed that patients with implanted cardiac pacemaker suffer
with mild anxiety. On the other hand it was observed that the age, type of
pacemaker, type of family, other illness identified had significant association
with respondents anxiety regarding pacemaker implantation. Further the sex,
marital status, educational level, occupational status, substance use, source
of information, religion .family income, duration of present illness, relaxation therapy are found non-significant association with anxiety among patients with implanted cardiac
pace maker. Hence it is concluded that respondents had mild anxiety when
implanted with cardiac pacemaker and should be ruled out to provide necessary
care and support for better adjustment and healthy living with cardiac
pacemaker device.
Implications of the
Study:
The findings of the study
have implications in the field of nursing practice, nursing education, nursing
administration and nursing research
Nursing Practice:
It helps the health care professionals to gain an insight into the
problems faced by cardiac pacemaker implanted patients. Nursing professionals
can provide psychotherapeutic care to the cardiac pacemaker implanted patients
in prevention and care regarding anxiety. Nursing professionals can motivate
the significant others and the family regarding care of cardiac pacemaker
implanted patients for adopting
appropriate coping strategies and follow up.
Nursing Education:
As a nurse educator, there are abundant opportunities for nursing
professionals to educate the students regarding care of patients with anxiety
who comes with implanted cardiac devices .The study can be extended for
educating the family members or the caregivers regarding effective management
of cardiac patients implanted with pacemaker. This study stresses the need for
in-service education for the nursing professional in order to consider
psychological aspect like anxiety while rendering physical care of patients
with cardiac pace maker.
Nursing Administration:
The nursing administrator can take part in developing protocols. The
nursing administrator can appoint nursing professionals based on the in-service
education obtained especially in the care of cardiac pacemaker implanted
patients regarding prevention and care patients with anxiety. The nurse
administrators should explore and encourage innovative ideas in the preparation
of an appropriate teaching material. She/he should organize sufficient
manpower; money and material for disseminating information regarding prevention
and care of anxiety among cardiac pacemaker implanted patients.
Nursing Research:
This study helps nurse researchers to conduct research on assessing
level of anxiety among cardiac pacemaker implanted patients. Research regarding
assessment of anxiety among cardiac pacemaker implanted cases can make students
to understand the need for acquaint the skills to provide psycho emotional care
to the patients.
Limitations
of the Study:
The study is limited to post implanted cardiac pacemaker patients of Shri Jayadeva cardiovascular
sciences and research hospital, Bengaluru. The study did not assess the other co morbid
aspects like depression. The samples for the study were limited to 60.
RECOMMENDATIONS:
On the
basis of the findings of the study following recommendations have been made. A
similar study can be replicated on large samples with random sampling to
generalize the findings. A study should be conducted in different settings to
generalize the findings. A study can be conducted by including additional
demographic variables. A comparative study can be conducted between temporary
and permanent pacemaker patients and between people with high and low socioeconomically
status. Manuals, information guide sheet, self-instruction module may be
developed in areas of prevention and care of patients with anxiety regarding
pacemaker implanted device.
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younger persons. 2005 Jul14. Available from: http://www.bukisa.com/articles/317740_pacemakers-for-younger-persons.
Received on 01.09.2015 Modified on 10.09.2015
Accepted on 21.09.2015 ©
A&V Publication all right reserved
Int. J. Nur. Edu. and Research 4(1):
Jan.-Mar., 2016; Page 31-41
DOI: 10.5958/2454-2660.2016.00006.5