Learning Self-care After Left Ventricular Assist Device Implantation

Abstract

The number of heart failure (HF) patients living with a left ventricular assist device (LVAD) as destination therapy is increasing. Successful long-term LVAD support includes a high degree of self-care by the patient and their caregiver, and also requires long-term support from a multidisciplinary team. All three components of self-care deserve special attention once an HF patient receives an LVAD, including activities regarding self-care maintenance (activities related both to the device and lifestyle), self-care monitoring (e.g., monitoring for complications or distress), and self-care management (e.g., handling alarms or coping with living with the device). For patients to perform optimal self-care once they are discharged, they need optimal education that focuses on knowledge and skills through a collaborative, adult learning approach.

Efficacy of Inpatient Rehabilitation After Left Ventricular Assist Device Implantation

“…All current LVADs require an external power source and system controller. Consequently, patients are required to have the physical and mental capacity to manage device components [3,4]. Numerous studies have demonstrated improved survival, functional status, and quality of life after implantation of continuous flow LVADs [5].…”

“…As this technology becomes increasingly common and more hospitals develop LVAD programs, awareness of the role of acute inpatient rehabilitation units (IRUs) as part of the multidisciplinary LVAD team is crucial and PM R XXX (2016) [1][2][3][4][5][6] www.pmrjournal.org may improve patient functional outcomes, quality of life, and length of stay (LOS). Previous studies have demonstrated the utility of the Functional Independence Measure (FIM) as a method for quantifying patient disability and level of assistance needed to carry out activities of daily living (ADLs) in numerous patient populations, including those with brain injury, Parkinson disease, spinal cord injury, and stroke [6][7][8][9][10].…”

Advancing the Science of Self‐Management in Adults With Long‐Term Left Ventricular Assist Devices

“…These topics are clustered around the IFSMT dimensions, which have been raised in the literature as pertinent variables or factors that may impact LVAD SM outcomes (3)(4)(5)(6)14,16,24). Since LVAD SM is actualized by patients in collaboration with family caregivers and VAD nurses/coordinators (3)(4)(5)(6)14,16), triadic longitudinal research designs will be imperative to explicate the caregiver and coordinators' contributions in LVAD SM Knowledge and beliefs Intervention to optimize LVAD care self-efficacy Explore interventions designed for individual goal setting and outcome expectations (e.g., goals for managing LVAD flows specific to the device and individual) Self-regulation skills and abilities Since LVAD SM is actualized by patients in collaboration with family caregivers and VAD nurses/coordinators (3)(4)(5)(6)14,16), triadic longitudinal research designs will be imperative to explicate the caregiver and coordinators' contributions in LVAD SM Knowledge and beliefs Intervention to optimize LVAD care self-efficacy Explore interventions designed for individual goal setting and outcome expectations (e.g., goals for managing LVAD flows specific to the device and individual) Self-regulation skills and abilities…”

“…This improvement in outcomes was attributed in part to the advancements in technology, surgical techniques, and postoperative management (1,2). The LVAD care regimen consists of several tasks and procedures performed by patients on a daily basis to maintain the normal workings of the LVAD system, prevent complications, reduce heart failure symptom burden and rehospitalization, and to ultimately optimize health and QOL (3)(4)(5). The LVAD care regimen consists of several tasks and procedures performed by patients on a daily basis to maintain the normal workings of the LVAD system, prevent complications, reduce heart failure symptom burden and rehospitalization, and to ultimately optimize health and QOL (3)(4)(5).…”

Improved aftercare in LVAD patients: Development and feasibility of a smartphone application as a first step for telemonitoring

“…2,3 Therefore, treatment with an LVAD requires continual monitoring of multiple parameters, also in the long term, in order to guarantee proper functioning of the system. 4,5 The present aftercare situation still leaves room for improvement, however, LVAD patients are currently requested to come to the outpatient unit of the treating heart center at regular intervals (usually every 3 months). On site, and only on that day, all relevant findings and parameters are collected.…”