Self-care in Adults With a Retro-auricular Left Ventricular Assist Device: An Interpretive Description

2021 ◽  
pp. 105477382110635
Author(s):  
Alessia Martina Trenta ◽  
Michela Luciani ◽  
Massimo Moro ◽  
Sara Patella ◽  
Stefania Di Mauro ◽  
...  
Keyword(s):  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Self Care ◽  
Left Ventricular ◽  
Interpretive Description ◽  
Structured Interviews ◽  
Care Needs ◽  
Assist Device ◽  
Ventricular Assist ◽  
Left Ventricular Assist

Having a retro-auricular left ventricular assist device (LVAD) requires patients to learn specific self-care behaviors, with a considerable burden; the present study aimed at exploring and describing the experience of self-care in this population. An Interpretive Description was conducted, informing the analysis with the Middle-Range Theory of Self-care of Chronic Illness. A purposeful sample of ten people with a retro-auricular LVAD participated in in-depth, semi-structured interviews. Four themes were identified: Innovations and Limitations in Daily Life, Problems Detection, Response to Problems, and Learning Process. All of these were deeply influenced by a cross-cutting theme: Support System. People with a retro-auricular LVAD have self-care needs different from those of people with heart failure or with the abdominal version of the device, and there is a great need for targeted intervention that could be developed in consideration of our findings.

Sleep and self-care correlates before and after implantation of a left-ventricular assist device (LVAD)

2018 ◽  
Vol 21 (3) ◽  
pp. 278-284 ◽  
Author(s):  
Jesus M. Casida ◽  
Jean E. Davis ◽  
Francis D. Pagani ◽  
James E. Aikens ◽  
Celeste Williams ◽  
...  
Keyword(s):  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Self Care ◽  
Left Ventricular ◽  
Assist Device ◽  
Ventricular Assist ◽  
Left Ventricular Assist ◽  
Before And After

Development of an Instrument for Measuring Self-Care Behaviors After Left Ventricular Assist Device Implantation

2019 ◽  
Vol 29 (4) ◽  
pp. 335-343
Author(s):  
Naoko P. Kato ◽  
Tiny Jaarsma ◽  
Jesus M. Casida ◽  
Christopher S. Lee ◽  
Anna Strömberg ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Self Care ◽  
Left Ventricular ◽  
Assist Device ◽  
Ventricular Assist ◽  
Left Ventricular Assist ◽  
Behavior Scale ◽  
Care Behavior

Background:Successful long-term left ventricular assist device (LVAD) therapy necessitates a high degree of self-care. We aimed to develop an instrument that measures self-care behaviors in adult patients living with an LVAD.Methods:We used the method to develop patient-reported outcomes recommended by the US Food and Drug Administration. Prior to developing the instrument, a literature review was conducted to generate items using the middle-range theory of self-care of chronic illness as a guiding framework. A 2-round Delphi method, involving 17 clinicians with expertise in heart failure and assist devices from the Netherlands, Israel, United States, Canada, and Japan, was used to generate and select items. In the first Delphi survey, the levels of importance, relevance, and clarity of items in the instrument were evaluated. The second Delphi survey was performed to gain consensus on the final selection of items. We also examined face validity.Results:A preliminary 37-item version of the Self-Care Behavior Scale was produced. The first panel judged 33 items as important and relevant, taking out 4 items due to vague wording and duplication and adding in 4 items. In the final 33-item version, 19 items address self-care maintenance behaviors, 10 items address self-care monitoring behaviors, and 4 items address self-care management behaviors. Patients (N = 25) did not have any difficulties understanding items and report any missing items.Conclusion:The 33-item Self-Care Behavior Scale for patients with heart failure having an LVAD has been developed and is ready for further psychometric testing.

Abstract 334: Confusion: Bereaved Caregiver Perspectives on the End-of-Life Experience with a Left Ventricular Assist Device

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Colleen K McIlvennan ◽  
Jacqueline Jones ◽  
Larry A Allen ◽  
Keith M Swetz ◽  
Carolyn Nowels ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Life Experience ◽  
Left Ventricular ◽  
Care Needs ◽  
Assist Device ◽  
Ventricular Assist ◽  
Left Ventricular Assist

Background: For patients and their loved ones, decisions at the end-of-life in the setting of chronic progressive illness are among the most complex in medicine. Complicating these decisions are increasingly available, invasive, and potentially life-prolonging technologies. One such technology is the left ventricular assist device (LVAD). Understanding the experience of dying with an LVAD can guide efforts to minimize distress for patients and their caregivers. Objective: To synthesize caregivers’ perspectives about the caregiver and patient experience with care transitions at end-of-life with LVAD. Methods: We conducted semi-structured, in-depth interviews with bereaved caregivers of patients with LVADs previously cared for at the University of Colorado. We excluded caregivers if the patient’s death had occurred greater than 3 years prior to the interview date. Data were analyzed using a mixed inductive and deductive approach. Results: Between September and November 2014, 8 bereaved caregivers were interviewed. Interview durations ranged from 31-65 minutes (mean=40). The majority (n=5) were widows of the patients; other caregivers included 2 friends and a mother. Caregivers described three main themes that coalesced around feelings of confusion in those final days and weeks with their loved ones: 1) confusion about the process of death with an LVAD: “[my daughter] said ‘You know Mom, he probably can't die. Even though he wants to. Because everything is keeping him going’”; 2) confusion about the legal and ethically permissible care of patients approaching death with an LVAD: “They don't actually turn it off until certain signs aren't there, ‘cause as long as there’s a chance you know? It would be considered murder.”; 3) confusion about the fragmented integration of palliative and hospice care: “He was bleeding again. And I didn't know what to do. I didn't know if we could take him to the ER? And I really didn't understand palliative care, in its entirety.” Conclusions: Despite increasing use of LVADs in patients with advanced heart failure, bereaved caregivers of LVAD patients describe a high level of confusion at the end of life: about the nature of the death, about the medical decisions to be made, and about the support services provided. There remains a need to develop LVAD-specific support for caregivers, as well as hospice and palliative care programs, to manage complex patient care needs at the end-of-life.

scholarly journals The consequences of the COVID ‐19 pandemic for self‐care in patients supported with a left ventricular assist device

2020 ◽  
Vol 22 (6) ◽  
pp. 933-936 ◽  
Author(s):  
Tuvia Ben Gal ◽  
Binyamin Ben Avraham ◽  
Miriam Abu‐Hazira ◽  
Maria Frigerio ◽  
Maria G. Crespo‐Leiro ◽  
...  
Keyword(s):  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Self Care ◽  
Left Ventricular ◽  
Assist Device ◽  
Ventricular Assist ◽  
Left Ventricular Assist

Ultrastructural observations of the aorta of calves implanted with a mechanical left ventricular assist device

1990 ◽  
Vol 48 (3) ◽  
pp. 834-835
Author(s):  
J P Cassella ◽  
V Salih ◽  
T R Graham
Keyword(s):  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
Aortic Tissue ◽  
Assist Device ◽  
Ventricular Assist ◽  
Transmission Electron ◽  
Left Ventricular Assist ◽  
Preliminary Study

Left ventricular assist systems are being developed for eventual long term or permanent implantation as an alternative to heart transplantation in patients unsuitable for or denied the transplant option. Evaluation of the effects of these devices upon normal physiology is required. A preliminary study was conducted to evaluate the morphology of aortic tissue from calves implanted with a pneumatic Left Ventricular Assist device-LVAD. Two 3 month old heifer calves (calf 1 and calf 2) were electively explanted after 128 days and 47 days respectively. Descending thoracic aortic tissue from both animals was removed immediately post mortem and placed into karnovsky’s fixative. The tissue was subsequently processed for transmission electron microscopy (TEM). Some aortic tissue was fixed in neutral buffered formalin and processed for routine light microscopy.

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