Academic Journal
Facilitators and Barriers to Values Discussions Following LVAD Implantation: Perspectives from Diverse Patients and Family Caregivers.
| Τίτλος: | Facilitators and Barriers to Values Discussions Following LVAD Implantation: Perspectives from Diverse Patients and Family Caregivers. |
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| Συγγραφείς: | Bechthold AC; School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama. Electronic address: abechth@uab.edu., Ejem DB; School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama., McIlvennan CK; Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, Colorado., Matlock DD; Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado; VA Eastern Colorado Geriatric Research Education and Clinical Center, Denver, Colorado., Knoepke CE; Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado., Lejeune J; Cardiology Clinic, UAB Hospital, Birmingham, Alabama., Bakitas MA; School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama., Odom JN; School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama. |
| Πηγή: | Journal of cardiac failure [J Card Fail] 2025 Sep; Vol. 31 (9), pp. 1393-1404. Date of Electronic Publication: 2024 Dec 19. |
| Τύπος έκδοσης: | Journal Article; Research Support, Non-U.S. Gov't; Research Support, N.I.H., Extramural |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Churchill Livingstone Country of Publication: United States NLM ID: 9442138 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8414 (Electronic) Linking ISSN: 10719164 NLM ISO Abbreviation: J Card Fail Subsets: MEDLINE |
| Imprint Name(s): | Publication: <2002->: Philadelphia, PA : Churchill Livingstone Original Publication: Naperville, IL : Churchill Livingstone, c1994- |
| Ιατρικοί όροι (MeSH): | Heart-Assist Devices*/psychology , Caregivers*/psychology , Heart Failure*/psychology , Heart Failure*/therapy, Humans ; Male ; Female ; Middle Aged ; Adult ; Aged ; Qualitative Research |
| Περίληψη: | Background: Delivering care that is responsive to who or what is most important to patients and family caregivers is a key aspect of quality care, yet it remains unclear how clinicians can best support individuals in expressing their personal values. We aimed to describe patient- and family caregiver-identified facilitators and barriers to engaging in values discussions with clinicians following implantation of a left ventricular assist device (LVAD). Methods and Results: Using a qualitative descriptive approach, patients with an LVAD and their caregivers participated in 1-on-1 semistructured interviews and self-reported sociodemographics (January 2023-July 2023). Qualitative data were analyzed using thematic analysis and descriptive statistics were computed for quantitative data. Results: Patients (n = 27; ages 30-76 years) were predominantly male (59%) and non-Hispanic Black (67%). Caregivers (n = 21; ages 27-76) were female (76%), non-Hispanic Black (67%), and a spouse/partner (62%). Facilitators (5 shared across patient/caregiver groups; 8 unique across patient/caregiver groups) included a perceived close relationship (patient/caregiver), values alignment (patient/caregiver), clinician discussion initiation (patient/caregiver), facing an impending decision (patient/caregiver), 1-on-1 dyadic interactions (patient/caregiver), being assertive (patient), positive dyadic communication (caregiver), and involvement of a third party (caregiver). Barriers (2 shared; 7 unique) included belief that their values are already known (patient/caregiver), sensitivity about values (patient/caregiver), uncertainty about timing (patient), poor clinical communication (patient), patient hopelessness (patient), perceived lack of clinician time (caregiver), and having a reserved personality (caregiver). Conclusion: Findings offer insight into actionable facilitators and barriers to discussions promoting incorporation of patient and family values into LVAD maintenance and chronic disease management. (Copyright © 2024 Elsevier Inc. All rights reserved.) |
| Grant Information: | UL1 TR001866 United States TR NCATS NIH HHS |
| Contributed Indexing: | Keywords: Communication; heart-assist devices; qualitative; values |
| Entry Date(s): | Date Created: 20241221 Date Completed: 20250915 Latest Revision: 20260413 |
| Update Code: | 20260414 |
| DOI: | 10.1016/j.cardfail.2024.11.015 |
| PMID: | 39709089 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1532-8414 |
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| DOI: | 10.1016/j.cardfail.2024.11.015 |