Experiences of adolescents with implanted defibrillators
Adolescents who are diagnosed with life-threatening cardiac arrhythmias requiring placement of an implantable cardioverter defibrillator (ICD) are at risk for psychosocial adjustment-related difficulties during an already tumultuous period of human development. These difficulties have the potential to interfere or delay the tasks associated with normal adolescent development. The purpose of this phenomenological study was to explicate the meanings of living with an ICD in the adolescent period of human development. A descriptive phenomenological approach using the central concepts described by Husserl was used as a framework to guide the study. The seven procedural steps outlined by Colaizzi were used for data analysis. Fourteen adolescents aged 13 - 18 years of age participated in semi-structured, audio taped interviews. Trustworthiness of the data was demonstrated through prolonged engagement with the adolescents, IO of whom participated in member checks; consultation with experts in adolescent development, ICDs in adults, and phenomenology; and generating thick description.An overall essence of Almost Normal and six themes depicting the lived experience of adolescents with ICDs emerged. The six themes included Life Interrupted, Still the Same Except, Sometimes It's Tough, It Cuts Both Ways, Unique Joule, and Living Life Regular. Findings revealed that adolescents with ICDs encountered a life-altering experience that required immediate lifestyle modifications and readjustments. Despite the disruption in their lives, the adolescents demonstrated resiliency, a positive sense of self, and rather than being delayed in the psychosocial and sociocognitive tasks of adolescence, had clearly established their own individual identities that revealed they were molded by their chronic condition but not defined by it. The essence of Almost Normal revealed the positive influence that normalization has on the lives of adolescents with chronic health conditions. This understanding of how adolescents live with I CDs on a daily basis supports the notion that the adolescent with a chronic health condition should be nurtured using a normalization versus an illness perspective. Recommendations are made for nursing practice, nursing research, and nursing education.