Essays on Cardiac Pacemakers

Essays on Cardiac Pacemakers

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Cardiac Pacemakers Essay Excerpts

…”Several investigators have studied reactions of patients requiring the implantation of cardiac pacemakers. Noting the initial anxieties of patients relative to the underlying cardiac disease and arrhythmias, they have delineated the concerns of these patients about relying on an artificial mechanical instrument, its unpleasant side effects, the possibility that batteries run out, and possible complications resulting from implantation. Blacher and Basch have identified three phases in the acceptance of pacemakers by patients: (1) the preoperative, characterized by concern with life and death, confrontation with the mystique of medical technology, fear of dependence on an artificial device that could fail, guilt, and pessimism; (2) the immediate posthospital phase characterized by depression; and (3) a later phase in which there has been acceptance of the pacemaker and the pursuance of normal activities, control and mastery of feelings, and preoccupation with physical sensations, fantasies, and denial. Crisp and Stonehill, comparing patients with external and internal pacemakers, noted that the former exhibited greater distress, and suggested that patients with implanted pacemakers were able to make greater use of denial as a defense mechanism in coping with an incurable disease”…

…”As hospitals are absorbing the technological advances that applied scientific research and methodology brought to medicine, specialized units have been established to cope with acute and specific problems. These intensive care units (ICU) and coronary care units (CCU) have evolved from hospital wards or recovery rooms into highly complex and specially constructed acute emergency units, requiringskilled nursing and medical technicians to operate the monitors, defibrillators, respiratory and suction apparatuses, and hypothermia units. In many ways, these units have become the symbol of the new frontier in medicine, its technological coming of age. As such they present a new unknown for the patient, his family, and the medical staff. Simultaneous with the development of these units, the hospital staff has noted an increasing incidence of behavioral disturbances among patients admitted to them, a phenomenon that Nahum has aptly identified as one of the "new diseases of medical progress." Consequently, the ICUs and CCUs have become foci of interest for the behavioral scientist in observing and identifying possible explanations for these syndromes that are estimated to occur 40-60 percent of the time. Kornfeld has developed four categories for the behavior observed in these units. Behavioral reactions associated with the medical and surgical illness and/or arising from metabolic, circulatory, or toxic factors. Hackett and his group, who have compiled extensive observations of patients in CCUs, emphasize the psychological reactions to illness of the patients admitted to the CCU…