Self-Care Management after Ventricular Assist Device Implantation: Recipient Needs and Experiences after Hospital Discharge

Abstract

Purpose Each year approximately 3,000 individuals with heart failure (HF) receive a ventricular assist device (VAD). Little is known about VAD recipients perceived needs for self-care management and experiences upon discharge from the hospital. The objectives of this study were to explore the perceptions of self-care management needs and challenges experienced as described by VAD recipients in the post-hospital discharge period (ranging from 2 months to 1-year post-implant). Methods In this qualitative descriptive study, one-on-one semi structured interviews were conducted with VAD recipients from an advanced HF program at a Midwestern academic medical center. The interviews focused on perceived needs for self-care management and recipient experiences after discharge from the hospital. The interviews were transcribed verbatim and recurring themes were identified through both independent and collaborative thematic content analysis using three reviewers. Results Twelve VAD recipients completed interviews; eight were male, four were female, all were White/Caucasian, non-Hispanic, and mean age was 56.5 ± 9.6. Half of participants had been implanted 6 months or less from the time of interview. Qualitative content analysis revealed 5 themes: (1) difficulties showering, (2) body image and what to wear, (3) feeling tethered, (4) importance of support system, and (5) lack of comfort with local community health care when living a distance from implant center. Conclusion These findings provide direction in terms of patients perceived needs for a post-discharge self-management intervention. Practical issues (e.g. showering, what to wear, and general VAD maintenance), as well as, broader psychological issues related to dependency on the VAD are a concern for recipients. Importance of the support system including VAD familiarity in local health care providers should be addressed.