What is the lived experience of patients with left ventricular assist devices during the COVID-19 pandemic? A qualitative analysis

Moving forwards to patient-centred care for patients with ventricular assist devices: A mixed methods study of nurses' perspectives

OBJECTIVES

To identify nurses' caring behaviours toward patients with left ventricular assist devices and deepen their understanding of experiences in nursing care. Patients with left ventricular assist devices require care in many aspects, but there is limited in-depth research about caring behaviours and experiences from the perspective of nurses providing care.

RESEARCH METHODOLOGY/DESIGN

Mixed methods study with a sequential explanatory design. Data were collected from clinical nurses with experience caring for patients using left ventricular assist devices in South Korea between May-August 2022.

MAIN OUTCOME MEASURES

Quantitative data (n = 79) were collected through an online survey of the Caring Behaviours Inventory - 24 and analysed using descriptive statistics. For qualitative data (n = 15), nurses' caring experiences were collected through individual interviews and analysed using Colaizzi's phenomenological method.

RESULTS

The overall average of caring behaviours was 4.80 ± 0.85, specifically, 'knowledge and skill' (5.04 ± 0.78), 'assurance' (5.01 ± 0.79), 'respect' (4.85 ± 0.90), and 'connectedness' (4.04 ± 0.99), respectively. The experience of caring was trapped in the uncomfortable reality of left ventricular assist device nursing, causing device-focused care, and approaching the essence of nursing through care focused on the patient's wholeness.

CONCLUSIONS

Caring for patients with a left ventricular assist devices was challenging for nurses. However, through the care process, they realised the meaning of patient-centred care, reflected in the essence of nursing, and sublimated it into an opportunity to grow.

IMPLICATIONS FOR CLINICAL PRACTICE

Nurses must focus on patient-centred care for left ventricular assist devices. To achieve this, it is essential to create a clinical environment and educational system for nurses to provide effective nursing care and enhance patient participation.

Describing post-traumatic stress disorder and its associations with depression, anxiety and insomnia: a descriptive study in Italian adults with Marfan syndrome during the COVID-19 third wave

OBJECTIVE

The evaluation of post-traumatic stress disorder (PTSD), depression, anxiety and insomnia in patients with Marfan syndrome (MFS) during the third wave of the COVID-19 pandemic in a region of northern Italy (Lombardy) and the investigation of which mental health, sociodemographic and clinical factors were associated with PTSD.

DESIGN

Descriptive observational design with cross-sectional data collection procedure.

SETTING

A single Italian MFS-specific specialised and reference centre in Lombardy (Italy) between February and April 2021.

PARTICIPANTS

112 adults with MFS. The majority of participants were female (n=64; 57.1%), with a high school diploma (n=52; 46.4%) and active workers (n=66; 58.9%). The mean age was 41.89 years (SD=14.00), and the mean time from diagnosis was 15.18 years (SD=11.91).

PRIMARY AND SECONDARY OUTCOMES

Descriptive statistics described PTSD, which was the primary outcome, as well as depression, anxiety and insomnia, which were the secondary outcomes. Four linear regression models described the predictors of PTSD total score and its three domains: avoidance, intrusion and hyperarousal.

RESULTS

One out of 10 patients with MFS had mild psychological symptoms regarding depression, anxiety and insomnia, and scores of PTSD that indicated clinical worries about the mental health status. The presence of PTSD was mainly predicted by anxiety (β=0.647; p<0.001), being older, taking psychoactive medication and being unemployed.

CONCLUSION

Depression, anxiety and insomnia should be monitored in patients with MFS in order to minimise PTSD insurgence. Specific psychosocial interventions should be developed and tested for this population and adopted in clinical practice, given the relevance of mental health outcomes during the pandemic.