The experience of body image for people with a left ventricular assist device

Gordon, Hannah (2020) The experience of body image for people with a left ventricular assist device. PhD thesis, Lancaster University.

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Abstract

This thesis is comprised of a systematic literature review, an empirical paper and a critical appraisal. Firstly, a systematic review and metasynthesis of qualitative studies exploring psychological experiences of adult heart transplant recipients was conducted. A metaethnographic approach was used to synthesise the findings of 12 papers. The results demonstrated that recipients underwent a process of making sense of their identity following transplantation. Recipients perceived that their psychological adjustment was impacted by the expectations of medical professionals, friends, family and wider society. They experienced fluctuating positive and negative emotions such as anxiety, grief and gratitude. Physical, social and psychological factors influenced coping and adaptation, contributing to better psychological wellbeing. Clinical implications are discussed. Secondly, the empirical paper explores experiences of body image for adults implanted with a left ventricular assist device (LVAD). Nine participants were interviewed, and the data were analysed using interpretative phenomenological analysis. The findings highlighted the importance of social, functional and appearance-related aspects of body image for LVAD-users. Participants re-evaluated their body with the LVAD and perceived that it, and themselves were “different”. They perceived their body as restricted and had a constant awareness of their body and device, which led to feelings of anxiety. LVAD-users used practical and psychological strategies to adjust to their changed body and perceive themselves as more “normal”. Clinical implications and limitations of the study are discussed, and further research is recommended. Finally, the critical appraisal offers a reflection on the process of conducting LVAD research including strengths and limitations. It also compares the findings of the review and empirical papers and recommends further areas for research.