Experiences of Transitioning to Home Care in Patients with Implantable Ventricular Assist Devices and their Caregivers

Abstract

The purpose of this study was to clarify the psychological distress and conflicts experienced by patients with Implantable Ventricular Assist Devices (VAD) and their caregivers with regard to home care as well as the changes in their health-related quality of life (SF36) and to consider nursing care based on the findings. The authors adopted a mixed method design wherein qualitative and quantitative studies were concurrently conducted. The participants in the qualitative study were 13 patients and 13 caregivers. The participants in the quantitative study were 19 patients and 10 caregivers. The authors collected and then analyzed data pertaining to the participants for the period spanning from immediately before discharge until 12 months after initial discharge from hospital. The results revealed that, even after they had returned to home care, the patients still faced problems of limited physical function and complication prevention, and they also struggled to adjust to society. The caregivers, on the other hand, were caring for such home-return patients in a self-sacrificial manner while struggling to cope with psychological distress. However, the psychological distress of both patients and caregivers was not reflected in their healthrelated quality of life. In addition, in the course of their home care-centered lifestyle, the patients and their caregivers─ each of whom experienced psychological distress─ exhibited mutual interactions and attempted to adjust to the lifestyle changes. It is necessary to understand the subjective experiences of patients and their caregivers and to adopt a continuous approach that commences from before the surgery.