'Being' a ventricular assist device recipient: A liminal existence

Soc Sci Med. 2017 Oct:190:141-148. doi: 10.1016/j.socscimed.2017.08.016. Epub 2017 Aug 19.

Abstract

Ventricular assist devices (VADs) are playing an increasing role in the management of heart failure. VADs are mechanical circulatory devices that support or replace the function of a failing heart. Currently, VADs are only offered in theUnited Kingdom (UK) to patients waiting for a heart transplant; however, the use of these devices is likely to increase in the near future. Presently, there is a dearth of literature exploring the day-to-day realities of living with a VAD, which will become increasingly important as the role of VADs is increased. This paper adopts an interpretive phenomenological approach to uncover the experience of 'Being' a VAD recipient. Semi-structured interviews were conducted with 20 VAD recipients. The overarching theme is that life with a VAD is a liminal existence. This comprised four subthemes: the first examines how the VAD imposes limitations on recipients' lives that can precipitate a loss of identity; the second focuses on temporal disruptions, recipients' sense of time changes from authentic to inauthentic; the third explores how the VAD itself is liminal, it is positioned as temporary rather than as the 'answer' to the condition; and finally, we discuss VAD recipients' projections to the future and the possibility of an end to the experience of liminality.

Keywords: Heart failure; Heart transplantation; Liminality; Phenomenology; United Kingdom; Ventricular assist device.

MeSH terms

  • Adult
  • Aged
  • Female
  • Heart Transplantation / instrumentation*
  • Heart Transplantation / psychology
  • Heart-Assist Devices / psychology*
  • Heart-Assist Devices / standards*
  • Humans
  • Male
  • Middle Aged
  • Qualitative Research
  • Quality of Life / psychology*
  • Time Factors
  • United Kingdom