Background International studies have examined patients’ views concerning the discussion of deactivating an implantable cardioverter defibrillator (ICD). Findings reported that many patients were either not informed about the subject or were informed late in their illness trajectory. Aim To explore healthcare professionals’ perspectives on discussing ICD deactivation and identify priorities for clinical practice and future research. Methods Eleven interviews were conducted, involving heart failure nurses, physicians, and an allied professional. All were responsible for the care of patients with an ICD, from the United Kingdom or Sweden. A semi-structured guide was used. All interviews were audio-recorded, transcribed, translated (as applicable) and analysed independently by experienced researchers, using framework analysis. Findings were presented, along with published work at a stakeholder meeting, and a consensus agreement was reached on priorities for clinical practice and future research. Findings Four themes emerged from the exploratory interviews. Healthcare professionals described the discussion about deactivation as challenging, requiring compassion and involvement of family members. They agreed that the topic should be initiated prior to, or shortly after device implantation. This was reflected in the priorities to improve communication, through the increased availability and implementation of prompts and tools, as well as the provision of tailored information to patients and family members. Stakeholders recognised the future potential of digital technology in device education. Conclusions Discussing deactivation remains challenging. Healthcare professionals recognised the need to initiate the discussion early, with compassion and involvement of family members. Priorities were agreed by stakeholders, which require clinical implementation and further research.

中文翻译：

---

深入了解医疗保健专业人员对讨论植入式心律转复除颤器停用的看法

背景 国际研究调查了患者对停用植入式心律转复除颤器 (ICD) 的讨论的看法。调查结果表明，许多患者要么没有被告知有关该主题的信息，要么是在其病情轨迹较晚时才被告知。目的 探讨医疗保健专业人员对讨论 ICD 停用的观点，并确定临床实践和未来研究的优先事项。方法 进行了 11 次访谈，涉及心力衰竭护士、医生和一名相关专业人员。所有人都负责护理来自英国或瑞典的带有 ICD 的患者。使用了半结构化指南。所有访谈均由经验丰富的研究人员使用框架分析进行录音、转录、翻译（如适用）和独立分析。在利益相关者会议上介绍了研究结果以及已发表的工作，并就临床实践和未来研究的优先事项达成了共识。结果 探索性访谈中出现了四个主题。医疗保健专业人士表示，关于停用的讨论具有挑战性，需要家庭成员的同情和参与。他们同意该主题应在设备植入之前或之后不久启动。这反映在通过增加提示和工具的可用性和实施​​以及向患者和家属提供量身定制的信息来改善沟通的优先事项上。利益相关者认识到数字技术在设备教育中的未来潜力。结论 讨论停用仍然具有挑战性。医疗保健专业人员认识到需要在家庭成员的同情和参与下尽早发起讨论。利益相关者商定了优先事项，需要临床实施和进一步研究。