Die Lebensqualität von Patienten mit implantierbarem Kardioverter-Defibrillator aus salutogenetischer Sicht: Eine qualitative Studie der kardiologischen Versorgungsforschung

BACKGROUND: Evidence on disease-related quality of life (DRQoL) of patients with implantable cardioverter-defibrillators (ICDs) has been described heterogeneously. Disease-specific measures of DRQoL in ICD patients are lacking. OBJECTIVES: The aim of this study was to gain a broader understanding of long-term DRQoL in ICD patients. Special focus was placed on stressors and cognitive management strategies in everyday life. METHODS: Data assessment was performed via semistructured, guideline-based interviews. The monocentric qualitative study included 10 ICD patients with primary and secondary prophylactic indication and 3 cardiologists. The qualitative analysis used the salutogenesis model (Antonovsky) as a framework. RESULTS: The interviews show that most patients do not experience a prominent limitation in their quality of life through the ICD. We found that patients focus on their individual coping strategies to handle the ICD indication with a sense of coherence, aiming at understanding their situation and giving it meaning. Whether the DRQoL is modified positively or negatively after ICD implantation depends on individual factors of resilience and factors of coherence. CONCLUSIONS: We established a salutogenic model for the assessment of DRQoL in patients with ICDs. A stable DRQoL on ICD implantation and follow-up could be achieved if patients at high risk (small sense of coherence and reduced resilience) are identified and their individual lifestyles are taken into account.