Adaptation and coping in patients living with an LVAD: A metasynthesis

作者：Abshire Martha^*; Prichard Roslyn; Cajita Mia; DiGiacomo Michelle; Himmelfarb Cheryl Dennison

来源：Heart & Lung, 2016, 45(5): 397-405.

DOI：10.1016/j.hrtlng.2016.05.035

• Adaptation
• Coping
• Left Ventricular Assist Device
• LVAD
• Heart failure

Objective: To synthesize information supporting coping and adaptation of LVAD patients and to identify opportunities for future interventions.
Background: Left Ventricular Assist Device (LVAD) patients demonstrate improvements in quality of life and functional status, but qualitative research has not been meaningfully integrated.
Methods: Qualitative meta-synthesis using Lazarus and Folkmans' Transactional Model of stress and coping.
Results: Four distinct stages of adaptation were identified: Pre-LVAD, Implant Hospitalization, Early Home Adaptation and Late Home Adaptation. Each stage includes tasks in physical, psychological and social domains. Two themes emerged: 1) Primary Appraisal: Every stage is a new challenge and 2) Secondary Appraisal: Routines are achievable, emotions are more difficult.
Conclusions: Emotional challenges including fear and anxiety related to life-limiting illness and changed social roles need to be honestly addressed. Individuals living with LVAD achieve a sense of independence, enjoy social interactions and meaningful activities through addressing practical and emotional problems to facilitate coping.

• 出版日期2016-10