Abstract 124: The Caregiver Experience of Caring for a Patient with a Left Ventricular Assist Device Patient: A Qualitative Meta-Synthesis
Background: The use of a left ventricular assist device (LVAD) is becoming increasingly common in patients with end-stage heart failure. Many LVAD programs require patients to have a caregiver before receiving a device.
Objectives: The aim of this study was to formally synthesize the qualitative literature specifically focusing on caregivers’ perceptions.
Methods: We searched Medline to find English-language articles on the topic of caregivers’ perceptions. A meta-synthesis, as an interpretive study of qualitative interpretive studies, was conducted to answer what caregivers perceive to be important in caring for an adult LVAD patient. Three levels of qualitative theme analysis and reciprocal translation were applied to the textual data.
Results: Eight articles met criteria for inclusion. The meta-synthesis across the articles resulted in several themes categorized under three domains. We noted that many of the articles suggested a longitudinal process of caregiving where perceptions are largely dependent on where caregivers are in the LVAD course. The first domain of caregiving is the “Early” stage covering the timeframe from life before the LVAD through surgical implantation. This phase is characterized by the pre-LVAD “emotional rollercoaster,” the decision seen as “no option,” and the thought of “leave it at the hospital.” The second domain is the “Middle” stage covering the timeframe from discharge home and going forward. This phase is characterized by fragility of the patient, recognition of a need to adapt, and a transformed life. The final domain is “Contextual” and describes how the LVAD indication (bridge to transplant or destination therapy) brings in to focus what is important to caregivers.
Conclusions: Existing literature indicates that the LVAD caregiver experience is intense, burdensome, and requires resiliency. Given the burdens they experience, clinicians and future research should explore strategies to support these important individuals.
Author Disclosures: D. Matlock: None. M. Magid: None. J. Jones: None. L. Allen: None. C. McIlvennan: None. J. Sterling: None.
- © 2014 by American Heart Association, Inc.