左心室辅助装置植入患者的适应与应对：一项综合分析。
Adaptation and coping in patients living with an LVAD: A metasynthesis.
作者信息
Abshire Martha, Prichard Roslyn, Cajita Mia, DiGiacomo Michelle, Dennison Himmelfarb Cheryl
机构信息
Johns Hopkins University School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205, USA.
Centre for Cardiovascular and Chronic Care, Faculty of Health, University of Technology, Sydney, Building 10, Level 6, Room 400, 235-253 Jones St, Ultimo, NSW 2007, Australia.
出版信息
Heart Lung. 2016 Sep-Oct;45(5):397-405. doi: 10.1016/j.hrtlng.2016.05.035. Epub 2016 Jun 21.
OBJECTIVE
To synthesize information supporting coping and adaptation of LVAD patients and to identify opportunities for future interventions.
BACKGROUND
Left Ventricular Assist Device (LVAD) patients demonstrate improvements in quality of life and functional status, but qualitative research has not been meaningfully integrated.
METHODS
Qualitative meta-synthesis using Lazarus and Folkmans' Transactional Model of stress and coping.
RESULTS
Four distinct stages of adaptation were identified: Pre-LVAD, Implant Hospitalization, Early Home Adaptation and Late Home Adaptation. Each stage includes tasks in physical, psychological and social domains. Two themes emerged: 1) Primary Appraisal: Every stage is a new challenge and 2) Secondary Appraisal: Routines are achievable, emotions are more difficult.
CONCLUSIONS
Emotional challenges including fear and anxiety related to life-limiting illness and changed social roles need to be honestly addressed. Individuals living with LVAD achieve a sense of independence, enjoy social interactions and meaningful activities through addressing practical and emotional problems to facilitate coping.
目的
综合支持左心室辅助装置（LVAD）患者应对和适应的信息，并确定未来干预的机会。
背景
左心室辅助装置患者的生活质量和功能状态有所改善，但定性研究尚未得到有效整合。
方法
采用拉扎勒斯和福克曼的应激与应对交易模型进行定性元综合分析。
结果
确定了四个不同的适应阶段：LVAD植入前、植入住院期、早期家庭适应期和晚期家庭适应期。每个阶段包括身体、心理和社会领域的任务。出现了两个主题：1） 初级评估：每个阶段都是一个新挑战；2） 次级评估：日常事务可实现，情绪调节更困难。
结论
需要诚实地应对包括与危及生命的疾病和社会角色改变相关的恐惧和焦虑等情感挑战。LVAD患者通过解决实际和情感问题以促进应对，从而实现独立感，享受社交互动和有意义的活动。
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