The quality of life after implantation of a pacemaker in patients’ opinion

Abstract

THE QUALITY OF LIFE AFTER IMPLANTATION OF A PACEMAKER IN PATIENTS’ OPINION

Introduction. Quality of life constitutes a very complex concept and includes all the spheres of the man’s functioning. On the grounds of medical sciences, quality of life is determined by health condition understood by functional effect of the disease and its treatment, experienced by the patient. It affects the physical condition and motor skills, mental condition, social situation, economic conditions as well as somatic experiences covering the mental condition of the patient. Health rhythm disturbances leading to symptomatic bradycardia constitute the life-threatening condition and have an impact on lowering the quality of life of the patient. Implanted pacemakers are not only complicated stimulation devices, but also the instruments saving lives, providing the sense of security and comfort of life [1,2].

Aim. The assessment of the quality of life of the patients after implantation of the pacemaker.

Material and methods. The patients after implantation of the pacemaker constituted the examined group (n=124). In the examination of the quality of life after implantation of the pacemaker the author’s standardised questionnaire was used. The following were applied for statistical analysis: the Mann–Whitney U test, the Kruskal–Wallis test, Kendall's tau (τ) coefficient and Kruskal’s gamma coefficient.
The questions of the survey were used to make measurement scales enabling to analyse the problems of daily life of the patients. The scales possess the ordinal character and allow implementing the statistical methods, such as: correlation coefficient, the Kruskal-Wallis ANOVA, the Mann-Whitney test. If necessary, the contingency variables and the chi-square test were used to examine the relationship between the qualitative variables. The specific answers to the questions were matched with the points, which after being added provided the size of the intensification of the phenomena described with a particular area.

Results: In the examined group the quality of life has improved in the analysed areas, the relationship between the variables depicting the particular spheres of the quality of life and age, marital status, education and vocational activity has been proved. In 62.90% (n=78) of the examined patients there has been improvement in health condition after implantation of the pacemaker, 45.97% (n=57) of the patients have increased their physical activity and effort whereas in 40.32% (n=50) of the patients the symptoms of arrhythmia have eased. According to 69.35% (n=86) of the examined patients the most negative aspect of life after implantation of the pacemakers is limited movement of the limb on the side of the implanted device, and 37.10% (n=46) have feared the  dysfunctions of the pacemaker.

Conclusions. The respondents describe their quality of life in a positive way. They have adapted to living with the implanted pacemaker and they have satisfaction from life despite the limitations that the pacemaker imposes. The statistical significance for the variables describing the particular areas of the quality of life and age, education, economic condition, relations with the relatives and the time from the moment of the implantation of the pacemaker was confirmed. The high level of anxiety caused by the fear of the possibility of dysfunctions of the pacemaker implicates the advisability of implementing additional form of medical care and education.