Taylor, Eleanor and Greasley, Pete (2018) Experiences of being maintained on a ventricular assist device. PhD thesis, Lancaster University.
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Abstract
This thesis explores the experiences of patients receiving cardiac support from two different types of ventricular assist device (VAD). The literature review focuses on the decisionmaking experience of patients and caregivers considering implantation of a left ventricular assist device (LVAD). The LVAD is a type of long-term/durable VAD which enables patients to be discharged from hospital. The literature review employed a thematic synthesis of the qualitative literature arriving at three major themes Context, Mechanism and Outcome. The synthesis proposes that decision-making is affected by Context and Mechanisms for both patients and caregivers which in turn leads to the theme Outcome. Context and Mechanism can be better understood by healthcare professionals by the third theme of Outcome. The research paper explores the experiences of patients who have undergone shortterm ventricular assist device (ST-VAD) support as an emergency procedure. The short-term ventricular assist device provides temporary cardiac support while a patient is in hospital. Participants in the research paper completed interviews which were then analysed using an Interpretative Phenomenological Analysis framework. Four superordinate themes are presented following the participants journey; (1) Crisis and the fragile nature of life, (2) “You adapt, you’ve got no choice”, (3) Moving on, (4) The change in me. The final section of the thesis comprises the author’s critical appraisal and reflections during the research process. The critical appraisal provides an opportunity for further reflection on the existential aspect of the VAD, the author’s professional development in the area of clinical health psychology, involving participants in the research process and clinical implications.