An existential-phenomenological study of living with an AICD (automatic implantable cardioverter defibrillator)

The automatic implantable cardioverter defibrillator (AICD) has been approved by the U.S. Food and Drug Administration as a treatment modality for persons with ventricular tachycardia since November 1985. Little is known about the impact of the device on the recipient's daily life. The purpose of this study is to uncover the impact that the device has on the recipient's day to day existence.

In order to answer the question: "What is the lived experience of people who have an AICD?" this study was conducted using an existential- phenomenological approach. Twelve recipients who have had the device at least six months were interviewed.

Data were analyzed using the Giorgi (1975, 1986) method of analysis. A situated structure for each subject is presented. Themes that emerged from the data were synthesized and abstracted into dimensions that form the general structure of living with an AICD. The context of the experience is the cardiac experience which is grounded in time. Dimensions of the experience are seen in the story of assimilation, an ongoing, dynamic process. The story of assimilation originates with the dimension of choice/no choice and contains dimensions of trust/absence of trust, understanding and support. A variety of syzygies related to trust andvii.understanding emerge as well as syzygies related to isolation and connectedness. From understanding, behaviors related to the physical presence of the device emerge. From the dimension of trust, actions of self-regulation appear. Metaphors related to the device and its action are presented, as well as descriptions of the actual "shock" experience in the subjects own words.

The findings are discussed in relation to Parse's (1981, 1992, 1995) theory of human becoming. Implications for nursing interventions and further research are addressed.