Academic Journal
The restore-adapt-abandon framework: supporting safe and meaningful living after ventricular assist device implantation.
| Τίτλος: | The restore-adapt-abandon framework: supporting safe and meaningful living after ventricular assist device implantation. |
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| Συγγραφείς: | Bechthold AC; College of Nursing, University of Tennessee Knoxville, Knoxville, TN, USA. Electronic address: abechtho@utk.edu., McIlvennan CK; Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA., Wells RD; School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA., Abshire Saylor M; School of Nursing, Johns Hopkins University, Baltimore, MD, USA., Moser DK; College of Nursing, University of Tennessee Knoxville, Knoxville, TN, USA., Matlock DD; Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA; VA Eastern Colorado Geriatric Research Education and Clinical Center, Denver, CO, USA., Odom JN; School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA. |
| Πηγή: | Heart & lung : the journal of critical care [Heart Lung] 2026 Oct 16; Vol. 80, pp. 102974. Date of Electronic Publication: 2026 Oct 16. |
| Publication Model: | Ahead of Print |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Mosby Country of Publication: United States NLM ID: 0330057 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1527-3288 (Electronic) Linking ISSN: 01479563 NLM ISO Abbreviation: Heart Lung Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: St. Louis, Mosby. |
| Περίληψη: | Background: Ventricular assist device (VAD) therapy improves survival and symptoms in patients with advanced heart failure but can impose lifestyle restrictions that challenge meaningful living. Engagement in meaningful activities is protective against all-cause mortality and positively impacts health, well-being, and quality of life, yet little is known about how VAD recipients adapt these activities post-implantation. Objectives: To explore how VAD recipients navigate meaningful activity engagement post-implantation, and present a clinically-relevant framework characterizing how VAD recipients engage in meaningful activities across the post-implant trajectory. Methods: We analyzed semi‑structured interview data from VAD recipients in the Southeastern U.S. and used thematic analysis to explore patterns of activity engagement and adaptation. Results: Two major themes emerged: (1) symptom relief enables restoration of activities and social roles; and (2) identity shifts and risk management prompt modified engagement. Across themes, patients described strategies and constraints including planning over spontaneity, managing device visibility and stigma, out-of-pocket costs, caregiver-linked mobility, and climate sensitivity. These patterns informed a "restore-adapt-abandon" framework for meaningful activity engagement across the post-VAD trajectory. Conclusion: Based on the findings, we recommend structured values elicitation, patient-clinician co-planning of activity adaptations, and identity-focused psychosocial support into routine VAD care. These strategies can optimize meaningful living alongside safety and redefine success in VAD therapy from survival alone to living well. (Copyright © 2026 Elsevier Inc. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors declare that there is no conflict of interest. |
| Contributed Indexing: | Keywords: Beliefs; Heart-assist devices; Patient preference; Patient-centered care; Values |
| Entry Date(s): | Date Created: 20261016 Latest Revision: 20261016 |
| Update Code: | 20261017 |
| DOI: | 10.1016/j.hrtlng.2026.102974 |
| PMID: | 42887217 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1527-3288 |
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| DOI: | 10.1016/j.hrtlng.2026.102974 |