Academic Journal
Values-Centered Discussions Among Family Caregivers of Patients with Left Ventricular Assist Devices: A Mixed Methods Study.
| Τίτλος: | Values-Centered Discussions Among Family Caregivers of Patients with Left Ventricular Assist Devices: A Mixed Methods Study. |
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| Συγγραφείς: | Thapa A; College of Nursing, University of Tennessee Knoxville, Knoxville, TN, USA., Saylor MA; School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA., Chehade M; NYU Rory Meyers College of Nursing, New York, NY, USA., Waldron W; Advanced Heart Failure Program, UT Medical, Knoxville, TN, USA., Tyson A; College of Medicine, University of Tennessee Health Science Center, Knoxville, TN, USA., Donald D; College of Nursing, Florida State University, Tallahassee, Florida, USA., Graven L; Florida State University College of Medicine, Department of Behavioral Sciences & Social Medicine, Tallahassee, Florida, USA., Cha G; College of Nursing, University of Tennessee Knoxville, Knoxville, TN, USA., Moser DK; College of Nursing, University of Tennessee Knoxville, Knoxville, TN, USA., McIlvennan CK; Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA; Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA., Bechthold AC; College of Nursing, University of Tennessee Knoxville, Knoxville, TN, USA. Electronic address: abechtho@utk.edu. |
| Πηγή: | Journal of cardiac failure [J Card Fail] 2026 Oct 10. Date of Electronic Publication: 2026 Oct 10. |
| Publication Model: | Ahead of Print |
| Τύπος έκδοσης: | Journal Article |
| 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- |
| Περίληψη: | Background: Family caregivers of left ventricular assist device (LVAD) recipients play a central role in managing complex care and navigating ongoing healthcare decisions. Although personal values may influence caregiving experiences and decision-making, little is known about how caregivers engage in values-centered discussions with the healthcare team. Objective: To examine LVAD caregivers' engagement in values-centered discussions and identify factors influencing these interactions. Methods: A sequential explanatory mixed methods study among LVAD caregivers at an outpatient mechanical circulatory support clinic in the Southeastern United States. Survey data were analyzed using descriptive statistics to summarize patterns of values-centered discussions. Interviews with a subset of participants were analyzed using thematic analysis to identify factors influencing these interactions. Quantitative and qualitative findings were integrated using joint displays. Results: Caregivers (N=32) reported high levels of feeling heard and understood in healthcare interactions (median [IQR], 3.50 [3.00-4.00] and moderate assertiveness in communicating care-related concerns (median [IQR], 7.00 [4.00-8.00]). Values discussions most often occurred with spouses/partners (75%), family members (69%), and LVAD coordinators (56%). Discussions were more common after implantation (89%) and during hospitalizations (93%) and clinic visits (86%) than via telehealth (31%). Three themes (n=11) explained these patterns: emotional readiness, relational trust, and situational context. Emotional overwhelm in the early post-implant period limited discussions, whereas trust, accessibility, and longitudinal relationships facilitated engagement. Conclusions: Values-centered discussions depend not only on opportunity but also emotional readiness, healthcare team relationships, and care context. Prioritizing relationship-building and ongoing opportunities for discussion may enhance engagement and support more value-concordant advanced heart failure care. (Copyright © 2026. Published by Elsevier Inc.) |
| Competing Interests: | Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Avery Bechthold reports financial support was provided by Sigma. Avery Bechthold reports financial support was provided by Hospice and Palliative Nurses Foundation. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
| Contributed Indexing: | Keywords: Beliefs; Caregivers; Heart-Assist Devices; Value; mixed methods |
| Entry Date(s): | Date Created: 20261010 Latest Revision: 20261010 |
| Update Code: | 20261011 |
| DOI: | 10.1016/j.cardfail.2026.09.028 |
| PMID: | 42858783 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1532-8414 |
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| DOI: | 10.1016/j.cardfail.2026.09.028 |