UT SON Dissertations (Open Access)

Date of Award

Spring 5-2020

Degree Name

Doctor of Philosophy in Nursing (PhD)

Advisor(s)

Jennifer E. Beauchamp, PhD

Second Advisor

Joan Engebretson, DrPH

Third Advisor

Rebecca L Casarez, PhD

Fourth Advisor

Nathan Carlin, PhD

Abstract

Background: Left Ventricular Assist Devices (LVADs) are used as advanced therapy for advanced heart failure in order to sustain patients until a heart transplant is available (bridge to transplant, ‘BTT’) or until the end of life (destination therapy, ‘DT’). Despite the differences in treatment trajectory, BTT and DT patients are provided the same education. Currently it is unknown if the two groups compare to living with the LVAD regarding adjustment.

Aims: The aim of this study was to explore LVAD patient experience, describe how patients construct the impact of the LVAD on daily life and self-care and compare the findings between BTT and DT patients. It is imperative to understand how BTT and DT LVAD recipients construct the patient experience in order to provide patient centric education for each group and promote optimal adjustment.

Methods: A general qualitative methodology was conducted with purposeful sampling of 20 LVAD recipients that self-reported either BTT or DT. Transcribed interviews were coded using Atlas.ti V8. Data content was analyzed, and once redundancy was reached relevant themes were identified through content analysis from exemplars.

Findings: Participants reported the overarching theme, Living with an LVAD is inconvenient, but life-sustaining. BTT and DT LVAD participants contrasted the LVAD patient experience in three phases, (1) illness perception, (2) LVAD adjustment, and (3) health aspirations. Six components were identified as important to LVAD adjustment among both groups: (1) physical ability, (2) caregiver dependence, (3) self-care, (4) roles, (5) LVAD public perception, and (6) connection. LVAD participants described differences in health aspirations based on the self-reported LVAD indication.

Conclusions: BTT and DT LVAD patients experience similar adjustment to the device. Despite the inconveniences of living with the LVAD, participants are grateful for the extended life. If faced with having to live with the LVAD for the remainder of life a majority of participants reported that it would not bother them, or they would be able to adjust. Increased knowledge regarding BTT and DT patient experience is required in to develop patient centric education and resources to ensure optimal LVAD adjustment.

Keywords

Left Ventricular Assist Device (LVAD), Adjustment, Heart Failure, Qualitative Research

Included in

Nursing Commons

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