Patient decision-making in left ventricular assist devices for destination therapy

Int J Palliat Nurs. 2024 Mar 2;30(3):108-117. doi: 10.12968/ijpn.2024.30.3.108.

Abstract

Background: Heart failure is a common life-limiting disease. A destination therapy for people who will not have a heart transplant is a left ventricular assist device.

Aims: To discover how patients who have a left ventricular assist device for destination therapy make decisions about their healthcare after implantation of the device.

Methods: A descriptive qualitative design with semi-structured, in-depth interviews with 11 participants who are living with a left ventricular assist device for destination therapy.

Findings: People with a left ventricular assist device felt they had 'no choice' when making decisions about their healthcare.

Conclusion: Engaging with patients to contemplate present and future healthcare decisions is a complex process that includes cognitive processes within the patient. Clinicians need to be aware that a gap may occur between what is said and what is heard in communication.

Keywords: Palliative; decision-making; destination therapy; left ventricular assist device; qualitative descriptive.

MeSH terms

  • Decision Making
  • Emotions
  • Heart Failure* / therapy
  • Heart-Assist Devices* / psychology
  • Humans