Wayne State University College of Nursing, Detroit, Michigan 48202, USA.
J Cardiovasc Nurs. 2011 Nov-Dec;26(6):504-11. doi: 10.1097/JCN.0b013e31820e2fae.
Left-ventricular assist devices (LVADs) sustain and improve the quality of life of people living with an advanced stage of heart failure. Past research focused on the development and advancement of LVAD technology, complications, and survival rates. Limited research addressed the psychosocial aspects of living with an LVAD, yet research related to sexual functioning and intimacy is lacking. The purpose of this study was to explore and describe sex and intimacy among adults living with an LVAD.
We used an interpretive phenomenological study to explore the experiences of adults living with a long-term implantable LVAD, including the effect of the LVAD on their intimate and sexual functioning. Semistructured interviews were conducted with 7 men and 2 women, 31 to 70 years of age, who had lived with the LVAD at home for at least 3 months. Interviews were audiorecorded and transcribed. The wholistic and selective approach by van Manen (Researching Lived Experience: Human Science for an Action Sensitive Pedagogy. Albany, NY: SUNY Press; 1990) guided the analysis and interpretation of the transcribed interviews. Data were organized and coded into words and phrases using qualitative software.
Three themes emerged from the data: (a) improved sexual relations with LVAD, (b) sexual adjustment, and (c) nonsexual intimacy. The themes identified were consistent with the concept of normalcy from the theory of self-care. Participants reported that as the LVAD improved their overall health, their sexual functioning also improved. Participants also reported an increased sense of connectedness and intimacy with their partners even in the absence of sexual intercourse. Participants discussed ways in which they continued to develop intimate relationships even in the presence of limitations in structural and functional integrity. The knowledge derived from this study can be used as a guide for healthcare providers in counseling LVAD recipients on psychosocial and sexual health essential for achieving an optimum quality of life.
左心室辅助装置（LVAD）可维持并提高处于心力衰竭晚期患者的生活质量。既往研究主要集中在 LVAD 技术的开发和进步、并发症和生存率上。有限的研究涉及到 LVAD 患者的社会心理方面，但缺乏与性功能和亲密关系相关的研究。本研究旨在探讨和描述使用 LVAD 的成年人的性和亲密关系。
我们采用解释性现象学研究方法，探讨了长期植入式 LVAD 患者的生活体验，包括 LVAD 对他们的亲密关系和性功能的影响。对 7 名男性和 2 名女性进行了半结构化访谈，年龄在 31 至 70 岁之间，他们至少在家中使用 LVAD 3 个月。访谈进行了录音并转录。van Manen（Researching Lived Experience: Human Science for an Action Sensitive Pedagogy. Albany, NY: SUNY Press; 1990）的整体和选择性方法指导了转录访谈的分析和解释。使用定性软件将数据组织并编码为单词和短语。
从数据中得出了三个主题：（a）与 LVAD 相关的性关系改善，（b）性调整，和（c）非性亲密关系。确定的主题与自我保健理论中的常态概念一致。参与者报告说，随着 LVAD 改善他们的整体健康，他们的性功能也得到了改善。参与者还报告说，即使没有性行为，他们与伴侣的联系和亲密感也增加了。参与者讨论了他们即使在结构和功能完整性受限的情况下，仍继续发展亲密关系的方式。从这项研究中获得的知识可以作为医疗保健提供者在咨询 LVAD 受者的社会心理和性健康方面的指南，这对于实现最佳生活质量至关重要。
