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. 2025 Mar;32(1):121-130.
doi: 10.1007/s10880-024-10024-6. Epub 2024 May 21.

Patient Information Needs and Decision-Making Before a Cardiac Implantable Electronic Device: A Qualitative Study Utilizing Social Media Data

Mitchell Nicmanis  1 , Joshua Holmes  2 , Melissa Oxlad  3 , Anna Chur-Hansen  3
Affiliations

Patient Information Needs and Decision-Making Before a Cardiac Implantable Electronic Device: A Qualitative Study Utilizing Social Media Data

Mitchell Nicmanis et al. J Clin Psychol Med Settings. 2025 Mar.

Abstract

The decision to receive a cardiac implantable electronic device (CIED) represents a challenging experience for patients. However, the majority of previous research has only considered retrospective accounts of patient experiences. This study aimed to use social media data to characterize the information sought by people anticipating or considering CIED implantation and factors that influence their decision-making experiences. A Python-based script was used to collect posts made to a community intended for discussions concerning CIEDs on the social media platform Reddit. Reflexive content analysis was used to analyze the collected data. From 799 posts collected, 101 made by 86 participants were analyzed. The reported median (range) age of participants was 34 (16-67), and most were anticipating or considering a pacemaker. Three overarching categories classified the data: "Use of social media to meet informational and other needs"; "Factors influencing acceptance of the need for implantation"; and "Specific concerns considered during decision-making." Participants anticipating or considering a CIED predominantly sought experiential information. Among asymptomatic participants, doubts were prevalent, with acceptance being an influential factor in decision-making. Healthcare professionals should recognize the informational and emotional needs of prospective CIED patients and tailor support mechanisms to better facilitate their decision-making.

Keywords: Cardiac implantable electronic device; Decision-making; Implantable cardioverter-defibrillator; Pacemaker; Qualitative.

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Conflict of interest statement

Declarations. Conflict of interest: Authors Mitchell Nicmanis, Joshua Holmes, Melissa Oxlad, and Anna Chur-Hansen declare that they have no conflict of interest. Ethics Approval: This study received ethical approval from the University of Adelaide School of Psychology Human Research Ethics Sub-Committee (approval number: 22/27). Specific Consent for Publication: In accordance with ethics approval, specific consent for publication was not required for this study as all data was publicly accessible. Human and Animal Rights: All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5).

Figures

Fig. 1
Fig. 1
Analysis structure including categories (gray) and subcategories (light gray). CIED cardiac implantable electronic device; n the occurrence frequency calculated based on the number of participants anticipating or considering a CIED who had produced corresponding textual data for each strata of the analysis
See this image and copyright information in PMC

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