Date Presented 03/23/24
A qualitative content analysis showed that left ventricular assist device (LVAD) candidates have diverse leisure interests, many of which require modification or avoidance postimplant. Activity-specific patient education implications will be shared to optimize leisure participation.
Primary Author and Speaker: Jessica Asiello
Additional Authors and Speakers: Brenna Bigenwald, Sophie D. Nash, Christina M. Kelley
Contributing Authors: Abigail Begin, Marissa Dittrich, Erin E. Donovan, Kimberly Beatty, Nicole C. Lam, Alyssa M. Taubert, Lisa Evans, Nicole Paul, Dana Kuhn, Kellie Cannone, Lauren McInnis
PURPOSE: Over 27k U.S. adults with heart failure have left ventricular assist devices (LVAD) (Yuzefpolskaya et al., 2023). Participation in leisure post-implant is key to improved quality of life (Levelink & Brütt, 2021), but integrating an LVAD into leisure is complicated by needing to protect equipment, ensure power sources, monitor for hemodynamic instability, and avoid water and fall risks. OTPs must be prepared to educate clients on modifications.
AIM: Understand preferred leisure occupations of adults with advanced heart failure who are LVAD candidates to inform OT intervention.
DESIGN: Cross-sectional analysis of a single variable from a large IRB-approved single-site cohort study of LVAD candidates.
METHOD: From 2019- 23, OTPs did occupational profile interviews as part of a pre-op LVAD evaluation protocol. Leisure data was extracted from the medical record. Qualitative content analysis was performed to code, abstract, interpret, and formulate themes (Lindgren et. al, 2020). A ‘stoplight’ model categorized activities as green for safe, yellow for caution / modification needed, and red for avoid. Results were debriefed with 7 OTPs with LVAD expertise using exercise physiology evidence (Kerrigan et al., 2022).
RESULTS: Of n=187 evaluations, 59% of LVAD candidates (n=111) cited 1-7 leisure preferences (M=1.1, SD=1.4). Content analysis revealed 48 distinct categories, led by being with family and friends (20%), arts & crafts (14%), walking (12%), fishing, golfing, and pets (10% each). 56% cited preferences that are safe, 63% that require modification, and 10% that must be avoided.
CONCLUSION: LVAD candidates have diverse leisure interests, many of which require modification or avoidance post-implant. By understanding pre-op preferences, OTPs can customize education to optimize leisure participation.
IMPACT: OTPs are leisure experts on interprofessional LVAD teams. Results informed activity-specific patient education handouts that will be shared at this poster.
References
Kerrigan, D. J., Cowger, J. A., & Keteyian, S. J. (2022). Exercise in patients with left ventricular devices: The interaction between the device and the patient. Progress in Cardiovascular Diseases, 70, 33–39. https://doi.org/10.1016/j.pcad.2021.12.002
Levelink, M., & Brütt, A. L. (2021). Factors influencing health-related quality of life of patients with a left ventricular assist device: A systematic review and thematic synthesis. European Journal of Cardiovascular Nursing, 20(8), 803–815. https://doi.org/10.1093/eurjcn/zvab056
Lindgren, B. M., Lundman, B., & Graneheim, U. H. (2020). Abstraction and interpretation during the qualitative content analysis process. International Journal of Nursing Studies, 108, 103632. https://doi-org.treadwell.idm.oclc.org/10.1016/j.ijnurstu.2020.103632
Yuzefpolskaya, M., Schroeder, S. E., Houston, B. A., Robinson, M. R., Gosev, I., Reyentovich, A., Koehl, D., Cantor, R., Jorde, U. P., Kirklin, J. K., Pagani, F. D., & D’Alessandro, D. A. (2023). The Society of Thoracic Surgeons Intermacs 2022 Annual Report: Focus on the 2018 heart transplant allocation system. The Annals of Thoracic Surgery, 115(2), 311–327. https://doi.org/10.1016/j.athoracsur.2022.11.023
