Adaptation and coping in patients living with an LVAD: A metasynthesis

Martha Abshire; Roslyn Prichard; Mia Cajita; Michelle DiGiacomo; Cheryl Dennison Himmelfarb

doi:10.1016/j.hrtlng.2016.05.035

Adaptation and coping in patients living with an LVAD: A metasynthesis

Heart Lung. 2016 Sep-Oct;45(5):397-405. doi: 10.1016/j.hrtlng.2016.05.035. Epub 2016 Jun 21.

Authors

Martha Abshire¹, Roslyn Prichard², Mia Cajita³, Michelle DiGiacomo², Cheryl Dennison Himmelfarb⁴

Affiliations

¹ Johns Hopkins University School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205, USA. Electronic address: Mabshir1@jhu.edu.
² Centre for Cardiovascular and Chronic Care, Faculty of Health, University of Technology, Sydney, Building 10, Level 6, Room 400, 235-253 Jones St, Ultimo, NSW 2007, Australia.
³ Johns Hopkins University School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205, USA.
⁴ Johns Hopkins University School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205, USA; Johns Hopkins University, School of Medicine, Baltimore, MD, USA.

Abstract

Objective: To synthesize information supporting coping and adaptation of LVAD patients and to identify opportunities for future interventions.

Background: Left Ventricular Assist Device (LVAD) patients demonstrate improvements in quality of life and functional status, but qualitative research has not been meaningfully integrated.

Methods: Qualitative meta-synthesis using Lazarus and Folkmans' Transactional Model of stress and coping.

Results: Four distinct stages of adaptation were identified: Pre-LVAD, Implant Hospitalization, Early Home Adaptation and Late Home Adaptation. Each stage includes tasks in physical, psychological and social domains. Two themes emerged: 1) Primary Appraisal: Every stage is a new challenge and 2) Secondary Appraisal: Routines are achievable, emotions are more difficult.

Conclusions: Emotional challenges including fear and anxiety related to life-limiting illness and changed social roles need to be honestly addressed. Individuals living with LVAD achieve a sense of independence, enjoy social interactions and meaningful activities through addressing practical and emotional problems to facilitate coping.

Keywords: Adaptation; Coping; Heart failure; LVAD; Left Ventricular Assist Device.

Publication types

Meta-Analysis
Review

MeSH terms

Adaptation, Physiological / physiology*
Adaptation, Psychological*
Emotions
Heart Failure / psychology*
Heart Failure / therapy
Heart-Assist Devices / psychology*
Humans
Qualitative Research
Quality of Life / psychology*

Abstract

Publication types

MeSH terms

Grants and funding