Family caregiver-reported outcomes regarding decision-making for left ventricular assist device implantation.
Barbara Birriel, Windy Alonso, Lisa A Kitko and 1 others
PMID 30981423WHAT IT FOUND
Family caregivers said LVAD implantation felt like the only option, not a choice.
They were mostly satisfied afterward, but were unprepared for discharge life, routines, and taking primary responsibility for the device.
Key findings
01All caregivers described LVAD implantation as not a decision, interpreting it as LVAD or death.
02Caregivers generally expressed satisfaction with the LVAD decision, though satisfaction fluctuated when recipients had complications.
03Despite feeling adequately informed before implantation, caregivers were unexpectedly unprepared for post-discharge routines and device responsibilities.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only caregivers whose family member received an LVAD were included, so the findings do not describe caregivers who declined implantation. The sample was small and mostly white and female, so it may not represent other family caregivers. The timing of interviews relative to implantation varied, which could affect recall of the decision-making period. The study describes caregiver experiences and themes, not whether any education, support, or discharge intervention worked.
Declared interests
The authors declared no conflicts of interest. The parent study was funded by NIH/NINR.
The easy way to misread this
Do not read caregiver satisfaction as proof that the decision was fully informed. All caregivers said the LVAD did not feel like a choice, and most could not recall specific details of treatment alternatives.