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American Journal of Critical Care. 2007;16: 72-81
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Psychosocial Issues for Patients with Ventricular Assist Devices: A Qualitative Pilot Study

By Elizabeth Chapman, BSc, PhD (Cantab), Jayan Parameshwar, MD, MPhil, FRCP, David Jenkins, BSc, MS, FRCS(C-Th), Stephen Large, MS, MA (Cantab), FRCS (Eng) FRCP, ILTM, MBA and Steven Tsui, MA, MD, FRCS (Eng), FRCS (C-Th). From the Centre for Family Research, University of Cambridge (EC), Papworth Hospital NHS Foundation Trust (JP, DJ, SL, ST), Cambridge, United Kingdom.

Corresponding author: Elizabeth Chapman, BSC, PHD, Senior Research Associate, Centre for Family Research, Free School Lane, Cambridge CB2 3RF, United Kingdom (e-mail: ecc22{at}cam.ac.uk).

• Background Surgical implantation of a ventricular assist device is being used increasingly in patients in the United Kingdom, yet few studies have focused on patients’ experiences from a phenomenological (psychological) perspective.

• Objective To explore, through a pilot study, the impact of implantation of a ventricular assist device on patients’ bodies and lives.

• Methods This qualitative retrospective study included 6 patients (4 men and 2 women) and 3 of these patients’ relatives. Patients were from 17 to 50 years old and had used Thoratec, Heartmate, or VentrAssist devices.

• Results The participants’ accounts clustered around a number of themes, 2 of which are reported here: (1) body and self and (2) trust. Each theme comprised several subthemes: body and self had sub-themes of shock, restrictions, scarring, and infection; trust had subthemes of keeping me alive, device failure, and confidence.

• Conclusions The ventricular assist device has a considerable effect on a patient’s body and sense of self. This effect is often accommodated without much difficulty, but some patients and their families need additional psychological support during and after use of a ventricular assist device. Assessment before implantation of such a device can sometimes reveal this need, but such assessment may not be possible in emergency procedures. Trusting the new heart or the native recovered heart may be difficult for some patients. Further research is needed to understand this phenomenon.






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