Modification of self-concept in patients with a left-ventricular assist device: an initial exploration

作者：Marcuccilli Linda^*; Casida Jesus; Peters Rosalind M

来源：Journal of Clinical Nursing, 2013, 22(17-18): 2456-2464.

DOI：10.1111/j.1365-2702.2012.04332.x

• cardiovascular
• phenomenological hermeneutics
• self-care
• self-concept

Aims and objectivesTo explore how patients with left-ventricular assist devices (LVAD) meet the health-deviation requisite of modifying self-concept to accept this form of treatment and restore normalcy. %26lt;br%26gt;BackgroundLVAD are becoming a standard option to improve the quality of life for patients with advanced heart failure. Past research focused on technology issues and survival rates, but limited research has addressed the effect of LVADs on patients%26apos; perceptions of self. Orem%26apos;s theory of self-care provides a framework to investigate how patients manage threats to self-concept to safely live with such a device. %26lt;br%26gt;DesignHermeneutic phenomenology based on van Manen%26apos;s method. %26lt;br%26gt;MethodData were collected using semi-structured interviews. Data saturation was achieved with nine participants (seven men; two women), 31-70years of age who lived with a LVAD at home for at least three months. Thematic analysis was ongoing, and final themes were consensually validated. %26lt;br%26gt;ResultsTwo themes constructed from the data were consistent with the requisite of modifying self-concept. First, Having a LVAD means living. Participants described they feel alive again%26apos;, and they had the rest of [their] lives that they didn%26apos;t have before%26apos;. The second theme: A desire to be normal%26apos; in public, arose from participants descriptions of how the LVAD brought unwanted attention to them and that their appearance was shocking%26apos; to others. %26lt;br%26gt;ConclusionParticipants accepted the LVAD as necessary to live making it easier for them to modify their self-concept and accept the changes to their bodies and daily lives. Attaining a sense of normalcy was more difficult in public and required additional lifestyle modifications. %26lt;br%26gt;Relevance to clinical practiceFindings advance self-care knowledge in LVAD management and can heighten nurses%26apos; awareness about self-concept as a vital component for maintenance of health and well-being.

• 出版日期2013-9