The Perceptions of Important Elements of Caregiving for a Left Ventricular Assist Device Patient: A Qualitative Meta-Synthesis.
The Perceptions of Important Elements of Caregiving for a Left Ventricular Assist Device Patient: A Qualitative Meta-Synthesis.
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DOI：
10.1097/jcn.0000000000000242
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发表时间：
2016-05
期刊：
影响因子：
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通讯作者：
Matlock DD
中科院分区：
文献类型：
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作者：
Magid M;Jones J;Allen LA;McIlvennan CK;Magid K;Thompson JS;Matlock DD
左心辅助装置(LVAD)在终末期心力衰竭患者中的使用正变得越来越普遍。许多LVAD计划要求患者在接受设备之前有护理人员。很少有研究探讨LVADs患者的经历、负担和对照顾者的影响。这项研究的目的是综合有关照顾者对护理成年左心室AD患者的看法的定性文献。我们检索Medline、CINAHL、ousInfo和Web of Science，查找关于左冠状动脉旁路移植术后照顾者感知的英文文章。然后使用定性综合集成的正式过程来合成这些文章。有8篇文章符合入选标准。所有文章的综合结果产生了八个主题，归类于三个领域。许多文章提出了一个纵向的护理过程，感知在很大程度上取决于与左冠状动脉成形术相关的面谈时间。护理的第一个领域是“早期”阶段，通过该程序涵盖左冠状动脉成形术之前的生活。这一阶段的特点是前LVAD的“情绪过山车”，被视为“没有选择”的决定，以及“把它[LVAD]留在医院”的想法。第二个领域是“中期”阶段，涵盖出院后的时间范围。这一阶段的特点是病人的脆弱，认识到需要适应，以及转变的生活。最后一个领域是“晚期LVAD”，描述了LVAD过程的后期，LVAD适应症(移植或目的地治疗的桥梁)带来了对照顾者重要的东西。现有文献表明，LVAD照顾者的经历是紧张、繁重的，需要适应新的生活。考虑到照顾者所经历的负担，临床医生和未来的研究应该探索支持这些重要个体的策略。
The use of a left ventricular assist device (LVAD) is becoming increasingly common in patients with end-stage heart failure. Many LVAD programs require patients to have a caregiver prior to receiving a device. There are few studies exploring the experience, burden, and impacts on caregivers of patients with LVADs. The aim of this study was to synthesize the qualitative literature regarding what caregiver’s perceptions about caring for an adult LVAD patient. We searched Medline, CINAHL, PsychInfo and Web of Science to find English articles on the topic of LVAD caregiver’s perceptions. The articles were then synthesized using a formal process of qualitative meta-synthesis. Eight articles met criteria for inclusion. The meta-synthesis across the articles resulted in eight themes categorized under three domains. Many of the articles suggested a longitudinal process of caregiving with perceptions largely dependent upon the time of interview in relation to the LVAD. The first domain of caregiving is the “early” stage covering life before the LVAD through the procedure. This phase is characterized by the pre-LVAD “emotional rollercoaster,” the decision seen as “no option,” and the thought of “leave it [the LVAD] at the hospital.” The second domain is the “middle” stage covering the timeframe following discharge from the hospital. This phase is characterized by fragility of the patient, recognition of a need to adapt, and a transformed life. The final domain is “late LVAD” and describes how late in the LVAD process, the LVAD indication (bridge to transplant or destination therapy) brings in to focus what is important to caregivers. Existing literature indicates that the LVAD caregiver experience is intense, burdensome, and the need to adapt to a new life. Given the burdens caregivers experience, clinicians and future research should explore strategies to support these important individuals.