Background: The use of left ventricular assist devices (LVADs) is increasing with an estimated 2500 devices implanted each year. When burdens of the LVAD outweigh benefits, most individuals with LVADs will undergo deactivation in the hospital setting. While the decision to deactivate an LVAD is considered an ethical practice, little is known about the experience and needs of bereaved family members.
Objective: To investigate the experiences of bereaved family members of patients who died following LVAD deactivation.
Methods: In this qualitative study, 11 family members of patients who underwent LVAD deactivation were interviewed. The semi-structured interviews were conducted until data saturation was reached and relevant themes emerged.
Results: This qualitative study was conducted to understand the experience of family members before, during and after the patient underwent LVAD deactivation, including their perceptions of engagement with the healthcare team. Analysis revealed six overarching themes from the experience, including 1) hope for survival, 2) communication, 3) spirituality and faith, 4) absence of physical suffering, 5) positive relationships with staff, 6) post-death care needs.
Conclusion: Bereaved family members of patients undergoing LVAD deactivation have unique lived experiences and concerns. This study highlights the importance of effective communication not only near end-of-life but throughout the LVAD experience. While the positive relationships with staff and the absence of physical suffering were strengths identified by bereaved caregivers, there is an opportunity for improvement, particularly during the decision-making and post-death periods.
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http://dx.doi.org/10.1016/j.hrtlng.2024.04.004 | DOI Listing |
J Perianesth Nurs
January 2025
Medical University of South Carolina, Charleston, SC. Electronic address:
Purpose: The purpose of the project was to reduce the occurrence of nonclinical delays resulting in increased postanesthesia care unit length of stay for carpal tunnel release patients in an ambulatory orthopedic surgery center through the implementation of new workflow processes in both the preoperative and postoperative phases of care.
Design: Pre-post design, with data being analyzed both before and after implementation of evidence-based quality improvement measures to assess for effectiveness of project interventions.
Methods: At the ambulatory orthopedic surgery center, preintervention data were gathered for 6 months on carpal tunnel release patients (n = 185) to determine the root causes of discharge delays (January to June 2023).
J Am Coll Cardiol
November 2024
Elite Centre for Individualized Medicine in Arterial Disease, Odense University Hospital, Odense, Denmark; Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Background: Prospective data on the clinical course of the ascending thoracic aorta are lacking.
Objectives: This study sought to estimate growth rates of the ascending aorta and to evaluate occurrences of adverse aortic events (AAEs)-that is, thoracic aortic ruptures, type A aortic dissections, and thoracic aortic-related deaths.
Methods: In this prospective cohort study from the population-based, multicenter, randomized DANCAVAS (Danish Cardiovascular Screening trials) I and II, participants underwent cardiovascular risk assessments including electrocardiogram-gated, noncontrast computed tomography (CT) scans.
Neuromodulation
January 2025
Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA.
Objectives: Biphasic sinusoidal repetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain stimulation treatment that has been approved by the US Food and Drug Administration for treatment-resistant depression (TRD). Recent advances suggest that standard rTMS may be improved by altering the pulse shape; however, there is a paucity of research investigating pulse shape, owing primarily to the technologic limitations of currently available devices. This pilot study examined the feasibility, tolerability, and preliminary efficacy of biphasic and monophasic rectangular rTMS for TRD.
View Article and Find Full Text PDFJ Am Coll Radiol
December 2024
Vice Chair for Radiology, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Co-Chair, RSNA Health Equity Committee; Associate Editor, Journal of the American College of Radiology.
Purpose: The aim of this study was to assess how pandemic-related health concerns and discrimination affected cancer screenings among Asian American women (AAW).
Methods: A two-phase explanatory mixed-methods study was conducted. In phase 1, a survey was distributed among AAW eligible for lung, breast, or colorectal cancer screening to assess delays during the pandemic, concerns about contracting coronavirus disease 2019 (COVID-19), barriers to care, and experiences of discrimination.
Afr J Reprod Health
December 2024
Heroes for Gender Transformative Action - Amref Health Africa, Uganda.
With 25% of teenagers pregnant by age of 19 and about half of these married before their 18th birth day, Uganda exhibits one of the highest rates of teenage pregnancy and child marriage globally. Comprehensive data on the drivers and barriers to addressing repeat teenage pregnancies and early child marriages remains limited. Using the narrative inquiry approach, the paper explores the key socio-cultural drivers and barriers to addressing repeat teenage pregnancies and early/forced marriages among stakeholders in the districts of Mbale, Kween, Namayingo and Kalangala.
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