UBC Graduate Research

Approaches to Support Ventricular Assist Device Patients in the Community : a Scoping Review Bagtas, Ninianne Alexis


Ventricular Assist Devices (VADs) are internally implanted mechanical circulatory pumps designed to augment cardiac function in patients with end-stage heart failure. These devices offer significant improvements in mortality and quality of life when compared to medical management alone. However the complexities of the device require specialized management even when patients are discharged from hospital. In response mechanical circulatory support (MCS) centres have developed a number of approaches to support patients living in the community along with their caregivers and community healthcare providers. However the nature and effectiveness of these approaches are unclear. A five-stage scoping review was conducted to identify the range, characteristics, and effectiveness of support approaches that have been reported. The theory of self-care of chronic illness was used to guide the analysis. CINAHL, PubMed/MEDLINE, the Web of Science, and Google Scholar were used to identify 17 studies. Studies were eligible for inclusion if they included a sample VAD patients, their caregivers, or their community healthcare providers, included an approach to outpatient care, and were delivered outside of the MCS centre. Seven themes were identified. MCS team support, close surveillance, resource provision, community provider as support, provider training, peer support, and educating family and friends represent the range of community support approaches reported in the literature. The principles of MCS centres as hubs of support, emergency preparedness, and the use of novel technologies characterize these approaches. These themes offer nurses and other MCS clinicians a catalogue of approaches to support the self-care of these patients in the community, as well as potential inspiration for the development and study of future community support initiatives for VAD patients, their families, and their community healthcare providers.

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