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Kugler C, Spielmann H, Albert W, Lauenroth V, Spitz-Koeberich C, Semmig-Koenze S, Staus P, Tigges-Limmer K. Professional Employment in Patients on Ventricular Assist Device Support-A National Multicenter Survey Study. ASAIO J 2024; 70:348-355. [PMID: 38170263 PMCID: PMC11057483 DOI: 10.1097/mat.0000000000002124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
This study aimed to assess patients of working age returning to professional employment as a surrogate marker for functional recovery and psychosocial reintegration after ventricular assist device (VAD) implantation. A national, multicenter study considered professional employment and its relationship to sociodemographic, psychosocial, and clinical adverse outcomes in outpatients on VAD support. Patient-reported outcome measures were administered. The survey had a 72.7% response rate. Mean age of 375 subjects was 58 ± 11 years, 53 (14%) were female. Thirty-five patients (15.15%; 95% confidence interval [CI] = 10.9-20.6) were employed, and the majority of them (n = 29, 82.9%) were bridged to transplantation. A regression model after variable selection revealed younger age (odds ratio [OR] = 0.95; 95% CI = 0.91-0.98; p < 0.005), and higher education (OR = 3.05; 95% CI = 1.72-5.41; p < 0.001) associated with professional employment. Employed patients reported higher health-related quality of life (HRQoL) (Kansas City Cardiomyopathy Questionnaire [KCCQ] overall sum-score, OR = 1.04; 95% CI = 0.92-1.07; p < 0.007), the OR for those employed was 2.18 (95% CI = 0.89-5.41; p < 0.08) indicating no significant relation for employment and a history of adverse events. In this sample, professional employment was rather small; the likelihood of adverse events was not significantly different between groups. Those employed perceived better overall HRQoL, which may encourage clinicians to support professional employment for selected patients on VAD support.
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Affiliation(s)
- Christiane Kugler
- From the Faculty of Medicine, Institute of Nursing Science, University of Freiburg, Freiburg, Germany
| | - Hannah Spielmann
- From the Faculty of Medicine, Institute of Nursing Science, University of Freiburg, Freiburg, Germany
| | | | - Volker Lauenroth
- Heart and Diabetes Center North-Rhine Westphalia, University Hospital of the Ruhr University Bochum, Bad Oeynhausen, Germany
| | | | | | - Paulina Staus
- Faculty of Medicine and Medical Center, Institute of Medical Biometry and Statistics, University of Freiburg, Freiburg, Germany
| | - Katharina Tigges-Limmer
- Heart and Diabetes Center North-Rhine Westphalia, University Hospital of the Ruhr University Bochum, Bad Oeynhausen, Germany
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Yoo HJ, Shin S. Mobile Health Intervention Contents and Their Effects on the Healthcare of Patients with Left Ventricular Assist Devices: An Integrative Review. Comput Inform Nurs 2024; 42:193-198. [PMID: 37607571 DOI: 10.1097/cin.0000000000001055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Self-care in daily life is important for patients with a left ventricular assist device. Mobile health interventions that use an application, the cloud, or telemonitoring enable active health management. This study reviewed the literature on the contents of mobile health interventions for patients with left ventricular assist devices and their effects. We searched four electronic databases (CINAHL, Cochrane Library, EMBASE, and MEDLINE) and reference lists in May 2022. The search terms consisted of "heart-assist devices" and "residence characteristics," combined with "mobile applications," "telemonitoring," "medical informatics applications," "cell*," "app*," "smartphone," and "cloud." In total, seven studies were included in the review. Mobile health interventions included (1) self-management contents and (2) interactions between patient and healthcare providers. The mobile health device and patient's health management were evaluated as a measure of the effect. This review provides a unique understanding for leveraging mobile health interventions as an effective approach to improve healthcare among patients with left ventricular assist devices. Future mobile health intervention strategies targeting these patients should fully consider the patient's perspective. Furthermore, they should be designed and applied to help with long-term health management, accompanied by an evaluation of their effectiveness on self-care improvement.
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Affiliation(s)
- Hye Jin Yoo
- Author Affiliations: College of Nursing, Dankook University, Cheonan (Dr Yoo); and Samsung Medical Center, Seoul, South Korea (Ms Shin)
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Fernández C, Vicente MA, Guilabert M, Carrillo I, Mira JJ. Developing a mobile health app for chronic illness management: Insights from focus groups. Digit Health 2023; 9:20552076231210662. [PMID: 37928329 PMCID: PMC10621305 DOI: 10.1177/20552076231210662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2023] [Indexed: 11/07/2023] Open
Abstract
Background Mobile applications have the potential to assist patients and caregivers in managing chronic diseases, but current offerings are typically limited to a single disease or only focused on patients. A multifaceted app could expand the user base and provide more comprehensive support for patients who usually suffer from diverse chronic conditions at the same time and their caregivers. Objectives This study aimed to design, develop, and evaluate a mobile application that could aid chronic patients and their caregivers in managing the range of chronic conditions. Methods Focus group meetings were conducted with patients and caregivers to identify their needs, which were translated into app functionalities. The final version of the app was evaluated through a survey and analysis of the most used features. Results Five focus group (FG) meetings were held, involving 39 patients and 22 caregivers. The app included medication aids, self-monitoring aids, activation reminders, messages for caregiver shifts, remote monitoring, medicine management, and informative videos. Testing by 65 patients revealed that medication reminders (96.8% positive responses), medicine information (96.8%), messages for caregiver shifts (90.3%), and ease of use (80.6%) were the most valued aspects. The most frequently used feature was the health data record check. Conclusions A multifaceted mobile application can address the needs of a variety of chronic patients and their caregivers, while still being easy to use. The app's most used functionalities were aligned with the needs expressed in the FG, which reflects the success of this study and suggests that future research could benefit from incorporating similar user-centered design methodologies.
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Affiliation(s)
- César Fernández
- Telematics Engineering, Miguel Hernandez University, Elche, Spain
| | | | | | - Irene Carrillo
- Health Psychology Department, Miguel Hernandez University, Elche, Spain
| | - José Joaquín Mira
- Health Psychology Department, Miguel Hernandez University, Elche, Spain
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Numan L, Moazeni M, Oerlemans MI, Aarts E, Van Der Kaaij NP, Asselbergs FW, Van Laake LW. Data-driven monitoring in patients on left ventricular assist device support. Expert Rev Med Devices 2022; 19:677-685. [DOI: 10.1080/17434440.2022.2132147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Lieke Numan
- Department of Cardiology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands
| | - Mehran Moazeni
- Department of Methodology and Statistics, Utrecht University, Heidelberglaan 8, 3584 CS, Utrecht, the Netherlands
| | - Marish I.F.J. Oerlemans
- Department of Cardiology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands
| | - Emmeke Aarts
- Department of Methodology and Statistics, Utrecht University, Heidelberglaan 8, 3584 CS, Utrecht, the Netherlands
| | - Niels P. Van Der Kaaij
- Department of Cardiothoracic Surgery, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Folkert W. Asselbergs
- Department of Cardiology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands
- Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, Gower Street, WC1E 6BT, London, UK
- Health Data Research UK and Institute of Health Informatics, University College London, Gower Street, WC1E 6BT, London, UK
- Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centre, University of Amsterdam, the Netherlands
| | - Linda W. Van Laake
- Department of Cardiology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands
- Institute of Health Informatics, Faculty of Population Health Sciences, University College London, Gower Street WC1E 6BT, London, UK
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Jedrzejewska A, Braczko A, Kawecka A, Hellmann M, Siondalski P, Slominska E, Kutryb-Zajac B, Yacoub MH, Smolenski RT. Novel Targets for a Combination of Mechanical Unloading with Pharmacotherapy in Advanced Heart Failure. Int J Mol Sci 2022; 23:ijms23179886. [PMID: 36077285 PMCID: PMC9456495 DOI: 10.3390/ijms23179886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 08/22/2022] [Accepted: 08/25/2022] [Indexed: 12/19/2022] Open
Abstract
LVAD therapy is an effective rescue in acute and especially chronic cardiac failure. In several scenarios, it provides a platform for regeneration and sustained myocardial recovery. While unloading seems to be a key element, pharmacotherapy may provide powerful tools to enhance effective cardiac regeneration. The synergy between LVAD support and medical agents may ensure satisfying outcomes on cardiomyocyte recovery followed by improved quality and quantity of patient life. This review summarizes the previous and contemporary strategies for combining LVAD with pharmacotherapy and proposes new therapeutic targets. Regulation of metabolic pathways, enhancing mitochondrial biogenesis and function, immunomodulating treatment, and stem-cell therapies represent therapeutic areas that require further experimental and clinical studies on their effectiveness in combination with mechanical unloading.
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Affiliation(s)
- Agata Jedrzejewska
- Department of Biochemistry, Medical University of Gdansk, Debinki 1 Street, 80-211 Gdansk, Poland
| | - Alicja Braczko
- Department of Biochemistry, Medical University of Gdansk, Debinki 1 Street, 80-211 Gdansk, Poland
| | - Ada Kawecka
- Department of Biochemistry, Medical University of Gdansk, Debinki 1 Street, 80-211 Gdansk, Poland
| | - Marcin Hellmann
- Department of Cardiac Diagnostics, Medical University of Gdansk, Smoluchowskiego 17, 80-214 Gdansk, Poland
| | - Piotr Siondalski
- Department of Cardiac Surgery, Medical University of Gdansk, Debinki 7 Street, 80-211 Gdansk, Poland
| | - Ewa Slominska
- Department of Biochemistry, Medical University of Gdansk, Debinki 1 Street, 80-211 Gdansk, Poland
| | - Barbara Kutryb-Zajac
- Department of Biochemistry, Medical University of Gdansk, Debinki 1 Street, 80-211 Gdansk, Poland
- Correspondence: (B.K.-Z.); (R.T.S.)
| | - Magdi H. Yacoub
- Heart Science Centre, Imperial College of London at Harefield Hospital, Harefield UB9 6JH, UK
| | - Ryszard T. Smolenski
- Department of Biochemistry, Medical University of Gdansk, Debinki 1 Street, 80-211 Gdansk, Poland
- Correspondence: (B.K.-Z.); (R.T.S.)
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Young L, D'Aoust RF, Budhathoki C, Casida JM. Proposed Mechanism of Adherence in Caregivers Providing Care to Adults Living with a Left Ventricular Assist Device. Prog Transplant 2022; 32:219-225. [PMID: 35726196 DOI: 10.1177/15269248221107045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The left ventricular assist device (VAD) is commonly used as the bridge-to-transplantation therapy for heart failure patients who are on waitlist of heart transplant. The caregivers' adherence to the homecare regimen plays a vital role in patient outcomes. There is little evidence about the factors related to the caregiver adherence. The purpose of this study was to determine the factors influencing adherence in caring for patients living with a left ventricular device. METHODS The data were collected from 4 online caregiver support groups. Multiple linear regression models were used to determine associations between key variables. The structure equation modeling was used to identify the mediators of caregiver adherence. RESULTS A total of 96 participants' data entered the final analysis. The average age of the participants was 49.8 (SD = 12.88) years, majority were white (84%), female (80%), and married (81%). Caregiver self-efficacy was positively related to their adherence (r = 0.460, P < 0.001). Caregiver knowledge did not mediate the effect of training on self-efficacy. Caregiver self-efficacy did not mediate the effect of knowledge on adherence. There was no interaction between practice hours and knowledge on adherence. DISCUSSION The findings suggest significant association between caregiver self-efficacy and adherence to left ventricular assist home-care regimens. Additional research is needed to identify factors influencing caregiver adherence, leading to the development of evidence-based practice guidelines and to improve the outcomes in advanced heart failure patients living with left VAD.
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Affiliation(s)
- Lufei Young
- College of Nursing, 1421Augusta University, Augusta, GA, USA
| | - Rita F D'Aoust
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | | | - Jesus M Casida
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
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Berg T, Benstoem C, Moza AK. VAD Patients' Perception of Potential Telemedicine Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073768. [PMID: 35409449 PMCID: PMC8998139 DOI: 10.3390/ijerph19073768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 11/16/2022]
Abstract
Technical possibilities for patient support must be user-friendly. This includes acceptance on the part of the patients, and safe function that must not lead to the user being overtaxed. In a study of Ventricular Assist Device (VAD) patients at the Department of Thoracic and Cardiovascular Surgery at the University Hospital RWTH Aachen, a questionnaire was used to investigate the current situation in dealing with the VAD system. This was followed by a query about ideas, wishes, and fears regarding the increased use of telemedical applications. An adapted Service User Technology Acceptability Questionnaire (SUTAQ) was used and the evaluation was carried out with the help of Office-based applications. As a result, it can be stated that the patients do not want to see personal contacts and care be completely replaced by telemedical remote support. If the application is stable and functioning, the majority is very much open to such support.
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Affiliation(s)
- Thomas Berg
- Department of Thoracic and Cardiovascular Surgery, Medical Faculty RWTH Aachen, 52074 Aachen, Germany;
- Correspondence:
| | - Carina Benstoem
- Department of Operative Intensive Care Medicine and Intermediate Care, Medical Faculty RWTH Aachen, 52074 Aachen, Germany;
| | - Ajay K. Moza
- Department of Thoracic and Cardiovascular Surgery, Medical Faculty RWTH Aachen, 52074 Aachen, Germany;
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8
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Evaluation of a Novel Virtual Care Platform for Remote Monitoring of LVAD patients. J Heart Lung Transplant 2022; 41:558-562. [DOI: 10.1016/j.healun.2022.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 01/20/2022] [Accepted: 02/09/2022] [Indexed: 01/05/2023] Open
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9
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Levelink M, Reinhold AK, Dewald O, Brütt AL. Psychological burden and coping in destination therapy patients with a left ventricular assist device: a qualitative content analysis. Artif Organs 2021; 46:1165-1180. [PMID: 34932234 DOI: 10.1111/aor.14158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 11/29/2021] [Accepted: 12/13/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Due to an increasing prevalence of heart failure and persistent shortage of donor hearts, the number of left ventricular assist device (LVAD) implantations is growing. As more patients live with LVADs for prolonged periods of time, psychosocial outcomes are becoming more relevant. This particularly applies to destination therapy (DT) patients, who live with the LVAD for the rest of their lives. METHODS We used a cross-sectional qualitative design to explore psychological burden, coping strategies and resources from the perspective of DT patients. Data was collected via semi-structured in-depth interviews with 18 patients who lived with the LVAD for 3 months to over 10 years. These were analyzed using an inductive content analysis. Due to the COVID-19 pandemic, changes to the recruitment strategy and data collection strategies of the original study protocol were applied. Patients and clinicians were involved throughout the research process to ensure validity of the results and implications. RESULTS We synthesized 10 psychosocial, health, and treatment-related burdens, identified 15 problem- and emotion-focused coping strategies and 5 personal and environmental resources patients used to cope with the burden. CONCLUSIONS The findings provide deeper insights into the complex and specific situation of LVAD patients to better address the patient situation in health care and promote positive psychosocial outcomes. So far, health care practice and quality vary significantly between clinics due to individual treatment protocols. Our results highlight the need to improve medical and psychosocial care. Overarching care concepts may be developed based on the implications.
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Affiliation(s)
- Michael Levelink
- Carl von Ossietzky Universität Oldenburg, Department für Versorgungsforschung, Nachwuchsgruppe Rehaforschung, Fakultät VI, Ammerländer Heerstr. 114-118, 26129, Oldenburg, Germany
| | - Anna Katharina Reinhold
- Carl von Ossietzky Universität Oldenburg, Department für Versorgungsforschung, Nachwuchsgruppe Rehaforschung, Fakultät VI, Ammerländer Heerstr. 114-118, 26129, Oldenburg, Germany
| | - Oliver Dewald
- Klinikum Oldenburg AöR, Universitätsklinik für Herzchirurgie, Oldenburg, Germany
| | - Anna Levke Brütt
- Carl von Ossietzky Universität Oldenburg, Department für Versorgungsforschung, Nachwuchsgruppe Rehaforschung, Fakultät VI, Ammerländer Heerstr. 114-118, 26129, Oldenburg, Germany
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10
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Casida JM, Pavol M, Budhathoki C, Craddock H, Schroeder SE, Hoff D, Tiburcio M, Ewald G. A pilot clinical trial of a self-management intervention in patients with a left ventricular assist device. J Artif Organs 2021; 25:91-104. [PMID: 34342807 DOI: 10.1007/s10047-021-01289-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/28/2021] [Indexed: 10/20/2022]
Abstract
Self-management is a health behavior known to predict treatment outcomes in patients with multiple co-morbidities and/or chronic conditions. However, the self-management process and outcomes in the left-ventricular assist device (LVAD) population are understudied. This pilot randomized control trial (RCT) evaluated the feasibility of a novel "smartphone app-directed and nurse-supported self-management intervention" in patients implanted with durable LVADs. Assessments included behavioral (self-efficacy and adherence), clinical (complications), and healthcare utilization (unplanned clinic, emergency room (ER) visits, and re-hospitalization) outcomes, completed at baseline (pre-hospital discharge) and months 1, 3, and 6 post-hospital discharge. Intervention patients (n = 14) had favorable patterns/trends of results across study outcomes than control patients (n = 16). Notably, intervention patients had much lower complications and healthcare utilization rates than controls. For example, intervention patients had 2 (14.3%) driveline infections in 6 months while control patients had 3 (19.0%). Additionally, at month 3, intervention patients had 0% ER visits versus 36% of control patients. At month 6, the mean cumulative number of re-hospitalizations for the control group was higher (0.9 ± 0.93) than intervention (0.3 ± 0.61) group. Despite the small sample size and limitations of feasibility/pilot studies, our outcomes data appeared to favor the novel intervention. Lessons learned from this study suggest the intervention should be implemented for 6 months post-hospital discharge. Further research is needed including large and rigorous multi-center RCTs to generate knowledge explaining the mechanism of the effect of self-management on LVAD treatment outcomes.
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Affiliation(s)
- Jesus M Casida
- Johns Hopkins University School of Nursing, Baltimore, MD, USA.
| | - Marykay Pavol
- New York-Presbyterian Columbia University Medical Center, New York, NY, USA.
| | | | - Heidi Craddock
- Barnes-Jewish Hospital Washington University, St. Louis, MO, USA
| | | | - Danyelle Hoff
- Barnes-Jewish Hospital Washington University, St. Louis, MO, USA
| | - Millie Tiburcio
- New York-Presbyterian Columbia University Medical Center, New York, NY, USA
| | - Gregory Ewald
- Barnes-Jewish Hospital Washington University, St. Louis, MO, USA
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11
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Levelink M, Brütt AL. Factors influencing health-related quality of life of patients with a left ventricular assist device: a systematic review and thematic synthesis. Eur J Cardiovasc Nurs 2021; 20:803-815. [PMID: 34263313 DOI: 10.1093/eurjcn/zvab056] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/04/2021] [Accepted: 06/07/2021] [Indexed: 11/14/2022]
Abstract
AIMS Left ventricular assist devices (LVADs) are increasingly being used in the treatment of advanced heart failure. Left ventricular assist device patients frequently report improvements in health-related quality of life (HRQOL) post-implantation. However, HRQOL varies over time and between patients, which can be explained by patient-related and environmental factors, as individual studies suggest. This review aims to synthesize qualitative evidence on factors influencing HRQOL of LVAD patients. METHODS AND RESULTS We systematically searched the databases PubMed, Scopus, PsycINFO, and CINAHL for qualitative studies on factors influencing HRQOL of patients with continuous flow LVADs. The included papers were synthesized using a thematic synthesis. The results were validated in discussion with a patient and practical implications were jointly developed. We included 11 papers and developed 7 themes that represent influencing factors for HRQOL of LVAD patients: disease experiences, emotional reactivity, heart failure and mechanical circulatory support symptoms, medical care, self-care, self-concept, and social environment. CONCLUSION The identified themes highlight influencing factors on HRQOL. These help to explain variation in patient outcomes and to better consider the individual situation in rehabilitation. Based on the results, four strategies are proposed for promoting psychosocial outcomes: facilitate self-care, ensure social support, offer psychosocial support, and manage patient expectations.
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Affiliation(s)
- Michael Levelink
- Department of Health Services Research, Carl von Ossietzky Universität Oldenburg, School of Medicine and Health Sciences, Ammerländer Heerstr. 114-118, Oldenburg 26129, Germany
| | - Anna Levke Brütt
- Department of Health Services Research, Carl von Ossietzky Universität Oldenburg, School of Medicine and Health Sciences, Ammerländer Heerstr. 114-118, Oldenburg 26129, Germany
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Schulman-Green D, Feder SL, Montano AR, Batten J, Tan H, Hoang K, Grey M. Use of the self- and family management framework and implications for further development. Nurs Outlook 2021; 69:991-1020. [PMID: 34183187 DOI: 10.1016/j.outlook.2021.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/20/2021] [Accepted: 05/02/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND The Self- and Family Management Framework (SFMF) was created in 2006 and revised in 2015 to guide research on self- and family management of chronic conditions. There has been no review of use of the SFMF. PURPOSE We reviewed articles citing the SFMF to identify the frequency and nature of use. METHOD We conducted a citation analysis, searching Web of Science, Scopus, and Google Scholar databases and extracted key data from identified articles. FINDINGS Of 126 articles, 84(66%) cited the 2006 SFMF, 37(29%) cited the 2015 SFMF, and 6(5%) cited both. The SFMF was used most to inform study design. Users noted strengths (e.g., considers family context) and limitations (e.g., non-specification of patient- family caregiver synergies) of the framework. DISCUSSION The SFMF has been used broadly to guide research on self- and family management of chronic conditions. Findings will inform development of a third version of the SFMF.
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Affiliation(s)
| | | | | | | | - Hui Tan
- Yale New Haven Health Bridgeport Hospital, Bridgeport, CT
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13
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Casida JM, Pavol M, Craddock H, Schroeder SE, Cagliostro B, Budhathoki C. Patient-Reported Issues Following Left Ventricular Assist Device Implantation Hospitalization. ASAIO J 2021; 67:658-665. [PMID: 33587467 DOI: 10.1097/mat.0000000000001381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The purpose of this study was to explore the information reported by patients via a smartphone application (VAD Care App) used for left ventricular assist device (LVAD) self-care monitoring and reporting post hospital discharge. Specific aims were to examine the type and frequency of issues reported by patients through the app during months 1, 3, and 6 postdischarge. An exploratory-descriptive research design was used with 17 patients (12 males and 5 females) with durable LVADs, mean age of 48.6 ± 16 years. Data generated by the patients' daily smartphone app usage more than 6 months were extracted from the server. Data were coded and clustered according to issues reported by patients via the app and analyzed with descriptive statistics. Three clusters of issues were found: physiologic, behavioral (self-care), and signs and symptoms. LVAD flows and pulsatility indices, hypertension, driveline care, and heart failure symptoms were worse at month 1, and then appeared to improve at months 3-6. However, abnormal levels of the international normalization ratio were common at all assessment points. Further research is needed to understand the mechanism of the reported issues on treatment outcomes, then develop and test interventions to inform evidence-based practice and clinical guidelines for smartphone apps used in LVAD self-care monitoring.
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Affiliation(s)
- Jesus M Casida
- From the School of Nursing, Johns Hopkins University, Baltimore, Maryland
| | - MaryKay Pavol
- Columbia University Medical Center, New York City, New York
| | - Heidi Craddock
- Barnes-Jewish Hospital Washington University, St. Louis, Missouri
| | | | | | - Chakra Budhathoki
- From the School of Nursing, Johns Hopkins University, Baltimore, Maryland
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Kugler C, Spielmann H, Seemann M, Lauenroth V, Wacker R, Albert W, Spitz-Koeberich C, Semmig-Koenze S, von Cube M, Tigges-Limmer K. Self-management for patients on ventricular assist device support: a national, multicentre study: protocol for a 3-phase study. BMJ Open 2021; 11:e044374. [PMID: 33952544 PMCID: PMC8103388 DOI: 10.1136/bmjopen-2020-044374] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 02/01/2021] [Accepted: 02/22/2021] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Self-management (SM) may facilitate patient participation and involvement to become active and knowledgeable partners in the care of complex chronic conditions such as ventricular assist device (VAD) therapy. The 'SM model for patients on VAD support' will serve to distinguish between SM components, and will guide the development, implementation and evaluation of an evidence-based curriculum. METHODS AND ANALYSIS This is a 3-phase, multicentre study. In phase 1, a prevalence study will be performed. Phase 2 aims to develop an evidence-based, interprofessional curriculum for SM support for VAD patients. In phase 3, a non-blinded block-randomised controlled trial (RCT), allocation ratio 1:1, intervention group superiority, with an unblinded multifacetted intervention with assessments before (T1) and after (T2) the intervention, and two follow-up assessments at three (T3), and 12 (T4) months after VAD implantation, will be performed. The curriculum guides the intervention in the RCT. Patient recruitment will consider centre-related volume: power analyses require 384 patients for phase 1, and 142 patients for phase 3. ETHICS AND DISSEMINATION Ethical considerations will be continuously taken into account and approved by the institutional review boards. Central ethical review board approval has been obtained by the Albert-Ludwigs University Freiburg. This study will be performed in concordance with the Declaration of Helsinki and the European data protection law. Publications will exclusively report aggregated data and will be distributed in the scientific community, and patient support groups. Report languages will be German and English. TRIAL REGISTRATION NUMBERS NCT04234230 and NCT04526964; Pre-results.
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Affiliation(s)
- Christiane Kugler
- Institute of Nursing Science, University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Hannah Spielmann
- Institute of Nursing Science, University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Maiken Seemann
- Institute of Nursing Science, University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Volker Lauenroth
- Medical Psychology, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Nordrhein-Westfalen, Germany
| | - Renata Wacker
- Psychosomatics, German Heart Center Berlin, Berlin, Germany
| | | | | | | | - Maja von Cube
- Institute of Medical Biometry and Statistics, University of Freiburg, Freiburg, Germany
| | - Katharina Tigges-Limmer
- Medical Psychology, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Nordrhein-Westfalen, Germany
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15
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A Comparative Content Analysis of Digital Channels for Ventricular Assist Device Patients, Caregivers, and Healthcare Practitioners. ASAIO J 2020; 65:855-863. [PMID: 30575626 DOI: 10.1097/mat.0000000000000924] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This article seeks to review and analyze the emergence of digital channels designed for ventricular assist device (VAD) patients, caregivers, and practitioners and to understand how such digital channels support the user experience of VAD implantation. Following a content analysis methodology, the authors investigated 16 digital channels designed for VAD patients, caregivers, and practitioners, with data being analyzed thematically. Competitor Positioning Matrix diagrams were created to visually represent the landscape of digital channels that support VAD stakeholders. These matrices identified opportunities and potential areas for improvement in future VAD digital channel design, with an emphasis on interactivity coupled with intelligence and focus along the various stages of the VAD patient journey. Innovation in digital channels has the potential to reduce burden on all users by enabling communication, self-management, and remote monitoring. Digital channels can be information enhanced for point of care, function as a decision support tools or be used to empower patient-caregiver pairs to be more sufficient with self-management, while enabling communication with their practitioner.
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16
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Barsuk JH, Cohen ER, Harap RS, Grady KL, Wilcox JE, Shanklin KB, Wayne DB, Cameron KA. Patient, Caregiver, and Clinician Perceptions of Ventricular Assist Device Self-care Education Inform the Development of a Simulation-based Mastery Learning Curriculum. J Cardiovasc Nurs 2020; 35:54-65. [PMID: 31738216 PMCID: PMC6895423 DOI: 10.1097/jcn.0000000000000621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Patients who undergo ventricular assist device (VAD) implantation and their caregivers must rapidly learn a significant amount of self-care skills and knowledge. OBJECTIVE The aim of this study was to explore patient, caregiver, VAD coordinator, and physician perspectives and perceptions of existing VAD self-care training to inform development of a simulation-based mastery learning (SBML) curriculum to teach patients and caregivers VAD self-care skills and knowledge. METHODS We conducted semistructured, in-person interviews with patients with a VAD, their caregivers, VAD coordinators, and physicians (cardiac surgeons, an infectious disease physician, and advanced heart failure cardiologists). We used a 2-cycle team-based iterative inductive approach to coding and analysis. RESULTS We interviewed 16 patients, 12 caregivers, 7 VAD coordinators, and 11 physicians. Seven major themes were derived from the interviews including (1) identification of critical curricular content, (2) need for standardization and assessment, (3) training modalities, (4) benefits of repetition, (5) piercing it all together, (6) need for refresher training, and (7) provision of training before implant. CONCLUSIONS Findings from this study suggest that SBML is a natural fit for the high-risk tasks needed to save VAD self-care. The 7 unique training-related themes derived from the qualitative data informed the design and development of a VAD SBML self-care curriculum.
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Affiliation(s)
- Jeffrey H. Barsuk
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Medical Education, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Elaine R. Cohen
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Rebecca S. Harap
- Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Chicago, IL, United States
| | - Kathleen L. Grady
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Jane E. Wilcox
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Chicago, IL, United States
| | - Kerry B. Shanklin
- Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Chicago, IL, United States
| | - Diane B. Wayne
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Medical Education, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Kenzie A. Cameron
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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17
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Schmidt T, Mewes P, Hoffmann J, Müller‐von Aschwege F, Glitza JI, Schmitto JD, Schulte‐Eistrup S, Sindermann JR, Reiss N. Improved aftercare in LVAD patients: Development and feasibility of a smartphone application as a first step for telemonitoring. Artif Organs 2019; 44:248-256. [DOI: 10.1111/aor.13560] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 08/05/2019] [Accepted: 08/13/2019] [Indexed: 12/27/2022]
Affiliation(s)
- Thomas Schmidt
- Schüchtermann‐Klinik Bad Rothenfelde Bad Rothenfelde Germany
- Institute for Cardiology and Sports Medicine, German Sports University Cologne Cologne Germany
| | - Philipp Mewes
- Schüchtermann‐Klinik Bad Rothenfelde Bad Rothenfelde Germany
- Technical University Dortmund Dortmund Germany
| | | | | | - Jenny I. Glitza
- OFFIS, Institute for Information Technology Oldenburg Germany
| | - Jan D. Schmitto
- Department for Cardiothoracic Transplantation and Vascular Surgery, Hannover Medical School Hannover Germany
| | | | | | - Nils Reiss
- Schüchtermann‐Klinik Bad Rothenfelde Bad Rothenfelde Germany
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18
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Reiss N, Schmidt T, Langheim E, Bjarnason-Wehrens B, Marx R, Sindermann JR, Knoglinger E. Inpatient Cardiac Rehabilitation of LVAD Patients-Updated Recommendations from the Working Group of the German Society for Prevention and Rehabilitation of Cardiovascular Diseases. Thorac Cardiovasc Surg 2019; 69:70-82. [PMID: 31170737 DOI: 10.1055/s-0039-1691837] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Cardiac rehabilitation physicians are faced to an increasing number of heart failure patients supported by left ventricular assist devices (LVAD). Many of these patients have complex medical issues and prolonged hospitalizations and therefore need special cardiac rehabilitation strategies including psychological, social, and educational support which are actually poorly implemented.Cardiac rehabilitation with clear guidance and more evidence should be considered as an essential component of the patient care plan especially regarding the increasing number of destination patients and their long-term follow-up.In this article the working group for postimplant treatment and rehabilitation of LVAD patients of the German Society for Prevention and Rehabilitation of Cardiovascular Diseases has summarized and updated the recommendations for the cardiac rehabilitation of LVAD patients considering the latest literature.
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Affiliation(s)
- Nils Reiss
- Schüchtermann-Klinik Bad Rothenfelde, Bad Rothenfelde, Germany
| | - Thomas Schmidt
- Schüchtermann-Klinik Bad Rothenfelde, Bad Rothenfelde, Germany.,Institute of Cardiology and Sports Medicine, German Sports University, Cologne, Germany
| | | | | | - Roger Marx
- MediClin Fachklinik Rhein/Ruhr, Essen, Germany
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