Abstract 4347078: Reclaiming Life Amid Constraint: The Ventricular Assist Device Experience

Abstract

Background: Ventricular assist device (VAD) implantation requires adoption of complex self-management routines, including device monitoring, dressing changes, assessing for complications, and responding to acute events. While these lifestyle changes significantly alter daily life, little is known about how VAD recipients adapt to these changes and sustain participation in valued roles and routines post-VAD implantation. Research Question: How do adult VAD recipients continue to engage in meaningful activities after implantation? Methods: A qualitative descriptive study was conducted among 12 adult VAD recipients from an outpatient clinic in the Southeastern U.S. Participants completed a semi-structured interview discussing changes in their ability to engage in meaningful activities after implantation. Thematic analysis identified key themes and subthemes. Results: Participants (n=12; ages 39–76 years; 42% rural) were predominantly male (67%), with half identifying as non-Hispanic Black (50%). Two themes emerged reflecting the dual impact of VAD implantation: (1) VAD support enables patients to reengage in meaningful activities, relationships, and roles; and (2) Patients must identify and avoid activities that pose a threat to their safety and well-being. Participants described a renewed ability to engage in light hobbies and household tasks after implantation, largely due to improved physical functioning, symptom relief, and extended survival. These improvements also allowed some to reclaim disrupted family and community roles. However, these benefits came with the need for increased planning and caution to avoid potentially hazardous situations. This involved modifying or giving up physically demanding, water-based, or spontaneous activities, as well as aspects of certain self-care and social activities, due to safety concerns and physical limitations. Changes also affected their self-expression and identity, with challenges with their clothing, intimacy, and independence. Despite these limitations, many expressed gratitude for the life-sustaining benefits of the VAD. Conclusions: These findings offer guidance for clinicians to help patients anticipate both increased engagement in certain meaningful activities and the need for lifestyle changes to ensure safety. Additional research is needed to identify predictors of continued engagement in meaningful activities post-VAD and long-term effects on psychological and device-related outcomes.