Decision-making for destination therapy left ventricular assist devices: implications for caregivers

Circulation. Cardiovascular Quality and Outcomes
Colleen K McIlvennanDaniel D Matlock

Abstract

Implanting centers often require the identification of a dedicated caregiver before destination therapy left ventricular assist device (DT LVAD) implantation; however, the caregiver experience surrounding this difficult decision is relatively unexplored. From October 2012 through July 2013, we conducted semistructured, in-depth interviews with caregivers of patients considering DT LVAD. Data were analyzed using a mixed inductive and deductive approach. We interviewed 17 caregivers: 10 caregivers of patients living with DT LVAD, 6 caregivers of patients who had died with DT LVAD, and 1 caregiver of a patient who had declined DT LVAD. The themes identified, which could also be considered dialectical tensions, are broadly interpreted under 3 domains mapping to decision context, process, and outcome: (1) the stark decision context, with tension between hope and reality; (2) the challenging decision process, with tension between wanting loved ones to live and wanting to respect loved ones' wishes; and (3) the downstream decision outcome, with tension between gratitude and burden. Decision-making surrounding DT LVAD should incorporate decision support for patients and caregivers. This should include a focus on caregiver burden and th...Continue Reading

References

Apr 4, 2007·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Brigitta BunzelErnst Wolner
Dec 19, 2009·Qualitative Health Research·Vaughan Marshall, Bonita C Long
Feb 26, 2010·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Mark S SlaughterUNKNOWN HeartMate II Clinical Investigators
May 12, 2010·Heart & Lung : the Journal of Critical Care·Kathy BakerMegan Maltby
Sep 8, 2010·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Sally BrushAbdallah G Kfoury
Feb 24, 2012·European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology·Morvarid Akbarin, Clara Aarts
Mar 7, 2012·Circulation·Larry A AllenUNKNOWN Council on Cardiovascular Surgery and Anesthesia
Apr 20, 2012·European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology·Ingrid Egerod, Dorthe Overgaard
Jan 8, 2013·Journal of the American College of Cardiology·Leslie W Miller, Maya Guglin
Jan 29, 2013·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·David FeldmanUNKNOWN International Society for Heart and Lung Transplantation
May 16, 2014·Circulation. Cardiovascular Quality and Outcomes·Colleen K McIlvennanDaniel D Matlock
May 27, 2014·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·James K KirklinJames B Young

❮ Previous
Next ❯

Citations

Feb 19, 2016·Current Opinion in Cardiology·Khadijah BreathettAmrut V Ambardekar
Jul 3, 2016·Heart Failure Clinics·Carrie Puckett, James O Mudd
Oct 8, 2016·Journal of Pain and Symptom Management·Karen NeohClare Rayment
May 22, 2016·Progress in Transplantation : Official Publication, North American Transplant Coordinators Organization ... [et Al.]·Giancarlo CicoliniValentina Simonetti
Jan 24, 2017·The American Journal of Bioethics : AJOB·Frances K BargJames N Kirkpatrick
Dec 13, 2017·The Journal of Cardiovascular Nursing·Aimee V HamelNiloufar Niakosari Hadidi
Jan 20, 2018·European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology·Holly C StandingTim Rapley
Mar 12, 2015·Circulation. Cardiovascular Quality and Outcomes·Patricia M Davidson, Michelle DiGiacomo
Jan 15, 2019·Circulation. Cardiovascular Quality and Outcomes·Colleen K McIlvennan, Daniel D Matlock
Aug 11, 2019·Journal of the American Geriatrics Society·Ersilia M DeFilippisVeli K Topkara
Mar 10, 2020·Circulation. Cardiovascular Quality and Outcomes·Colleen K McIlvennanTimothy S Sannes
May 1, 2020·Circulation·Lisa KitkoUNKNOWN American Heart Association Council on Cardiovascular and Stroke Nursing; Council on Quality of Care and Outcomes Research; C
May 20, 2020·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Daniel D MatlockLarry A Allen
Oct 23, 2018·Applied Health Economics and Health Policy·Jordana K SchmierPrem A Midha
Feb 6, 2017·Heart Failure Reviews·J Nicholas Dionne-OdomUNKNOWN IMPACT-HF National Workgroup
Sep 13, 2019·Circulation. Cardiovascular Quality and Outcomes·Colleen K McIlvennanLeslie Curry
Feb 4, 2021·Circulation. Cardiovascular Quality and Outcomes·Jocelyn S ThompsonDan D Matlock
Jul 24, 2020·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Manreet K KanwarJennifer Cowger
Nov 24, 2021·Journal of Gerontological Social Work·M Pilar IngleChristopher E Knoepke

❮ Previous
Next ❯

Related Concepts

Related Feeds

Artificial Heart & Ventricular Assist Devices

Total artificial hearts (TAH) and ventricular assist devices (VADs) provide cardiac support for patients with end-stage heart disease and have significantly improved the survival of these patients. Discover the latest research on Artificial Heart and Ventricular Assist Devices here.