"Talking Around It": A Qualitative Study Exploring Dyadic Congruence in Managing the Uncertainty of Living With a Ventricular Assist Device.
Lyndsay G DeGroot, Julie T Bidwell, Anna C Peeler and 3 others
PMID 33605640WHAT IT FOUND
Patients with a ventricular assist device grew less anxious as they adjusted, but caregivers stayed on alert.
Many participants avoided or talked around end of life, and only some dyads matched on how they think about death.
Key findings
01Patients' worry tended to decrease as they gained confidence in managing the device, while caregivers' worry continued.
02Most participants avoided or talked around end of life, and none discussed device deactivation.
03Dyads agreed most about quality of life and meaning, but only about half matched on how they think about end of life.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study included only 10 dyads from one clinic, so it cannot show how common these views are. The sample had limited caregiver types and racial or ethnic diversity, with most caregivers being spouses or partners. The end-of-life questions did not always produce rich answers, and for many participants this was their first direct discussion of death. The themes were not validated back with the participants. People scoring below 17 on the cognitive screen were excluded, so more impaired patients and caregivers were not represented.
Declared interests
The supplied text does not state author conflicts of interest. The article is tagged as supported by NIH and non-U.S. government research.
The easy way to misread this
Do not read this as evidence that a communication programme works. It describes what people with a ventricular assist device and their caregivers said about uncertainty and end of life, not the effect of any tested intervention.