Lisa A Kitko1, Judith E Hupcey2, Barbara Birriel2, Windy Alonso2. 1. College of Nursing, The Pennsylvania State University, USA. Electronic address: lkitko@psu.edu. 2. College of Nursing, The Pennsylvania State University, USA.
Abstract
OBJECTIVES: To examine patients' pre-implantation decision-making and pre and post-implantation expectations of left ventricular assist devices (LVADs). BACKGROUND: LVADs have been shown to improve both quantity and quality of life of patients living with Stage D heart failure (HF). However, they also pose significant risks. METHODS: 15 LVAD participants followed in a longitudinal study of Stage D HF patients were included in this thematic analysis. RESULTS: Three themes were identified: no choice; I thought I would be doing better; I feel good, but now what. Evidence from pre-implantation to post-implantation suggested that patients' perceived expectations of quality of life improvement were not met. CONCLUSIONS: In light of their declining health, most patients felt their only alternative to implantation was death. In the post-implantation period, patients expected greater improvements in their quality of life. Evidence based guidelines for discussions of goals of care, post-implant expectations, and palliative care are necessary.
OBJECTIVES: To examine patients' pre-implantation decision-making and pre and post-implantation expectations of left ventricular assist devices (LVADs). BACKGROUND:LVADs have been shown to improve both quantity and quality of life of patients living with Stage D heart failure (HF). However, they also pose significant risks. METHODS: 15 LVADparticipants followed in a longitudinal study of Stage D HF patients were included in this thematic analysis. RESULTS: Three themes were identified: no choice; I thought I would be doing better; I feel good, but now what. Evidence from pre-implantation to post-implantation suggested that patients' perceived expectations of quality of life improvement were not met. CONCLUSIONS: In light of their declining health, most patients felt their only alternative to implantation was death. In the post-implantation period, patients expected greater improvements in their quality of life. Evidence based guidelines for discussions of goals of care, post-implant expectations, and palliative care are necessary.
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