Presentation Title l August 16, 2015 l 1 Patient Perception: Quality of Life Before and After...

Presentation Title l April 19, 2023 l 1

Patient Perception: Quality of Life Before and After Pacemaker Implantation

Dedra TeelMarymount Hospital


• The Heart– Organ composed of muscle to pump

blood throughout the body

– Composed of 4 chambers

– Beats approximately 72 times per

minute

Cardiac Function

• Blood flow is controlled by the Sinus Node

• The sinus node sends electrical impulses to the Atrioventricular Node where the impulses are slowed down to allow the ventricle to fill completely before pumping out to the rest of the body

Pacemaker Comparison

Size of shoe polish can

Lasted 3 hours

Plutonium battery

Size of a ½ dollar coin

Lasts 5 to 11 years

Lithium-ion battery

Pacemaker: How it works

• 2 components

–Pulse Generator

–Positioned in a pocket under the clavicle

–Leads

–Electrical wires threaded through the subclavian vein that enters the right atrium and right ventricle

• The battery can detect irregular heart beats and sends appropriate electrical impulses


Pacemaker Purpose

• To maintain an adequate heart rate which relieves patients of dizziness, fatigue, weakness, and shortness of breath due to insufficient amount of oxygen in the blood

• To help the heart pump properly to maintain a healthy heart rate


Hypothesis

• The purpose of this study is to evaluate patient’s perceptions of their quality of life before and after pacemaker implantation

• It is hypothesized that there will be an overall improvement in quality of life after pacemaker implantation. Also, females will be better able to express the improvement that they noticed

• Physical abilities were also being observed in both genders, however the greatest improvement in physical limitations will be seen in females


Methodology

• This study consisted of 17 patients interviewed before and after pacemaker implantation

• Interviews were conducted primarily in person at Marymount, however follow up phone calls were also administered. Participating patients were asked 13 questions regarding their physical and mental health

• The questions were based on the Qualitymetric sf12v2 Health Survey


Data


Average Age: 85

Highest: 94

Lowest: 72Ages of Participants

Num

ber

of R

espo

nses

Indications for Pacemakers

• Atrial fibrillation – irregular electrical impulses from the atria that causes the heart to quiver

• Bradycardia – when an individual has a resting heart rate of below 60 beats per minute. It can cause shortness of breath, dizziness, and fainting

• Tachycardia – when the heart rate exceeds 100 beats per minute. A high heart beat is more demanding of the heart itself to get oxygen throughout the body

• Tachybrady syndrome – describes a patient with intermittent fast and slow heart rates

• Heartblock – condition that affects transmission of impulses through the heart. It can result in ` abnormally low heart rate


Patient Indications


Indication Responses

Atrial Fibrillation 1

Bradycardia 10

Heartblock 5

Description of Health Before


Description of Health After


Results

• 35% of patients felt an improvement in their overall health

• 41% remained the same

• 24% had a decline in their description of health

• 81% of males felt improvement or remained the same

• 67% of females felt improvement or remained the same

Physical Limitations Before


Physical

Activity

Not at all A little A lot

Vigorous Activities

6 4 7

Moderate Activities

9 6 2

Climbing Stairs

12 1 4

Bending or Kneeling

8 7 2

Physical Limitations After

Physical

Activity

Not at all A little A lot

Vigorous Activities

5 3 9

Moderate Activities

8 7 2

Climbing Stairs

8 6 3

Bending or Kneeling

10 5 2

Results

• 18% of patients had decreased physical limitations

• 47% stayed the same before and after

• 35% felt an increase in physical limitations

• 72% of males had a decrease in physical limitations or remained the same

• 50% of females had a decrease in physical limitations or remained the same

Quality of Life Before


Number of Patients

Num

ber

of R

espo

nses

Quality of Life After


Num

ber

of R

espo

nses

Number of Patients

Results

• 35% of patients had an improvement in their quality of life

• 47% remained the same

• 18% felt a decline in their quality of life

• 82% of males had an improvement quality of life or remained the same

• 83% of females had an improvement quality of life or remained the same

Conclusions

• Description of Health–Patients descriptions of health went from a

standard bell curve in the Before graph to a more centralized After graph with “Very Good” as the most common response. This is an overall improvement from the Before graph that had an emphasis on the “Good” description.

–76% had an increased or maintained the same description of health.

Conclusions

• Physical limitations-Only 18% felt physical activities became

easier however, 47% remained the same-A difficulty of this study was patients accounting other illnesses or conditions as a part of their

physical limitations. In many cases, patients are admitted with another diagnosis and then receive a pacemaker during their stay


Conclusions

• Quality of Life–Over 82% of both males and females felt a

improvement or stayed the same for their quality of life

–Consistent with hypothesis by a small margin

– Only a fifth of the study population felt their quality of life declined. Conditions beside heart problems may have influenced patient’s responses


Recommendations


It is recommended that this study be repeated with a larger sample population. The investigation should place a greater emphasis on cardiac conditions to limit outside influences in responses.

Acknowledgments

Mentors:Cathy Cerny CNPDonna Waite MD

Office of Civic Education:Rosalind StricklandNedra Starling, MPH, ABD


Presentation Title l August 16, 2015 l 1 Patient Perception: Quality of Life Before and After...

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