Circ Cardiovasc Qual
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Circ Cardiovasc Qual · May 2014
Choices for patients "without a choice": Interviews with patients who received a left ventricular assist device as destination therapy.
Patients undergo major physical and psychological changes after implantation of a left ventricular assist device as destination therapy (DT). We sought to qualitatively study outcomes and attitudes of patients after DT. ⋯ Ambulatory patients reported varied experiences after DT but commonly reported gratitude for improved functional status and a perception of improved symptom burden. Recommendations for improving post-DT care include developing patient support systems, systematizing education for community providers, and expanding respite services.
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Circ Cardiovasc Qual · May 2014
Decision making for destination therapy left ventricular assist devices: "there was no choice" versus "I thought about it an awful lot".
Destination therapy left ventricular assist devices (DT LVADs) are one of the most invasive medical interventions for end-stage illness. How patients decide whether or not to proceed with device implantation is unknown. We aimed to understand the decision-making processes of patients who either accept or decline DT LVADs. ⋯ Some patients offered a DT LVAD face the decision by reflecting on a process and reasoning through risks and benefits. For others, the desire to live supersedes such reflective processing. Acknowledging this difference is important when considering how to support patients who are faced with this complex decision.
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Circ Cardiovasc Qual · May 2014
Editorial CommentPeering inside the black box of patient-centered care.