LVAD patients' and surrogates' perspectives on SPIRIT-HF: An advance care planning discussion

Heart Lung. 2016 Jul-Aug;45(4):305-10. doi: 10.1016/j.hrtlng.2016.05.033.

Abstract

Objectives: To describe LVAD patients' and surrogates' experiences with, and perspectives on SPIRIT-HF, an advance care planning (ACP) intervention.

Background: ACP is important for patients with LVAD, yet little is known about their experiences or those of their surrogates who have participated in ACP discussions.

Methods: We used qualitative content analysis techniques to conduct a secondary analysis of 28 interviews with patients with LVAD (n = 14) and their surrogates (n = 14) who had participated in an RCT pilot study of SPIRIT-HF.

Results: Main themes from the data include: 1) sharing their HF stories was very beneficial; 2) participating in SPIRIT-HF led to greater peace of mind for patients and surrogates; 3) "one size does not fit all" when it comes to timing of ACP discussions.

Conclusions: An understanding patient and surrogate perspectives may inform clinicians' approach to ACP discussions.

Keywords: Advance care planning intervention; End-of-life; Family members; LVADs; Perspectives; Surrogates.

MeSH terms

  • Adult
  • Advance Care Planning / standards*
  • Aged
  • Decision Making*
  • Female
  • Heart Failure / psychology
  • Heart Failure / surgery*
  • Heart-Assist Devices*
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Qualitative Research*
  • Retrospective Studies