"Why Would I Choose Death?": A Qualitative Study of Patient Understanding of the Role and Limitations of Cardiac Devices

The Journal of Cardiovascular Nursing
Rachel A HadlerDio Kavalieratos

Abstract

Although cardiology organizations recommend early introduction of palliative care for patients with heart failure (HF), integration has remained challenging, particularly in patients with cardiac devices such as cardiac implantable electronic devices and left ventricular assist devices. Study authors suggest that patients often have limited and erroneous understanding of these devices and their implications for future care. The aim of this study was to assess perceptions of cardiac devices in patients with HF and how these perceptions impacted advance care planning and future expectations. This study used qualitative semistructured interviews with 18 community-dwelling patients with New York Heart Association stage II to IV HF. We interviewed 18 patients (mean ejection fraction, 38%; mean age, 64 years; 33% female; 83% white; 39% New York Heart Association class II, 39% class III, and 22% class IV). All had a cardiac implantable electronic device (6% permanent pacemaker, 56% implantable cardioverter-defibrillator, 28% biventricular implantable cardioverter-defibrillator); 11% had left ventricular assist devices. Patients with devices frequently misunderstood the impact of their device on cardiac function. A majority expressed t...Continue Reading

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Citations

Aug 11, 2019·Journal of the American Geriatrics Society·Ersilia M DeFilippisVeli K Topkara
Feb 23, 2020·The Journal of Cardiovascular Nursing·Michela LucianiDavide Ausili
May 1, 2021·European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology·Jenny WisingPeter Magnusson

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