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患者使用心室辅助装置的心路历程:VAD 协调员的视角。

Psychological Journey of a Patient With a Ventricular Assist Device: A VAD Coordinator's Perspective.

机构信息

Karen Meehan is Advanced Practice Nurse, MCS Coordinator, Department of Cardiac Surgery, University of Chicago Medical Center, 5841 S. Maryland Avenue, Suite E500, MC5040, Chicago, IL 60637 (

Sarah E. Schroeder is MCS Nurse Practitioner and Program Manager, Division of MCS Therapy, Bryant Heart, Lincoln, Nebraska.

出版信息

AACN Adv Crit Care. 2021 Dec 15;32(4):443-451. doi: 10.4037/aacnacc2021744.

Abstract

BACKGROUND

A thorough psychosocial assessment is needed during the evaluation of candidacy for ventricular assist device placement to identify potential barriers that would limit success with the device. Ventricular assist device coordinators are generally involved in the psychosocial assessment of the patient, allowing them to provide a more holistic approach to ventricular assist device candidacy during discussions at multidisciplinary meetings. There is a gap in the literature describing the psychological journey of patients after ventricular assist device implantation and the challenges ventricular assist device coordinators face when caring for this complex population.

OBJECTIVE

The psychological journey of 3 patients with a ventricular assist device was explored to determine if common themes exist and to describe the experiences faced by the ventricular assist device coordinators with each patient.

METHODS

Three patient case scenarios are described, as are the interactions with the patients' ventricular assist device coordinator team members.

RESULTS

All 3 case scenarios demonstrate similarities of younger ages, the need of family and social support, and ventricular assist device coordinators who went beyond the call of duty to assist in the successful heart transplantation for 2 cases and the successful decommission of the ventricular assist device in another case.

CONCLUSION

The psychosocial needs of patients with a ventricular assist device and ventricular assist device coordinators require ongoing assessment because of the many physical and emotional challenges that arise during the time a patient has an implanted ventricular assist device.

摘要

背景

在评估心室辅助装置植入的候选资格时,需要进行全面的社会心理评估,以确定可能限制患者使用该装置成功的潜在障碍。心室辅助装置协调员通常参与患者的社会心理评估,使他们能够在多学科会议的讨论中为心室辅助装置候选资格提供更全面的方法。目前文献中存在一个空白,描述了心室辅助装置植入后患者的心理历程,以及心室辅助装置协调员在照顾这一复杂人群时面临的挑战。

目的

探讨 3 名心室辅助装置患者的心理历程,以确定是否存在共同主题,并描述心室辅助装置协调员与每位患者的互动情况。

方法

描述了 3 个患者案例情景,以及与患者的心室辅助装置协调员团队成员的互动情况。

结果

所有 3 个案例情景都表现出相似的年龄较轻、需要家庭和社会支持,以及心室辅助装置协调员超越职责范围,协助 2 例成功进行心脏移植,另 1 例成功停用心室辅助装置。

结论

由于患者植入心室辅助装置期间会出现许多身体和情绪上的挑战,因此需要对患者和心室辅助装置协调员的社会心理需求进行持续评估。

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