Advancing the Science of Self‐Management in Adults With Long‐Term Left Ventricular Assist Devices

Abstract

This study tested the applicability of the individual and family self-management theory (IFSMT) to self-management (SM) in patients with left ventricular assist devices (LVADs). From an existing data set, we extracted the following variables that correspond to IFSMT's conceptual dimensions: anxiety, depression, and cognition (context dimension); self-efficacy (SM process dimension); adherence and quality of life (QOL; outcome dimensions). Descriptive statistics and partial least squares path modeling procedures were used for data analyses. A total of 100 patients (mean age 52 ± 13.4 years) with continuous flow LVAD designs comprised the present study. Most patients were White (78%), married (69%), college-educated (72%), and on disability (53%). Their mean anxiety and depression scores were slightly above normal, while their cognitive function scores were slightly lower than normal. LVAD care self-efficacy, adherence, and QOL were within normal ranges. Factor loadings ranged from 0.50 to 1.0, and there were significant forward path relationships among the context, process, and outcome dimensions (β ranges from 0.02 to 0.60, all P values < 0.05). In conclusion, the IFSMT provides a good fit for SM in LVAD. Further research is needed to clarify how best to improve LVAD SM practice and treatment outcomes.

Artificial Organs 2018: A Year in Review

“…Jesus Casida et al of the University of Michigan, Ann Arbor, MI, USA, evaluated the applicability of the individual and family self‐management theory (IFSMT) to self‐management (SM) in patients with left ventricular assist devices (LVADs). In 100 patients most were white (78%), married (69%), college‐educated (72%), and on disability (53%).…”

Self‐management program for adolescents with chronic kidney disease: A randomized controlled trial

“…It is known that theory‐based approaches to the development of self‐management behaviours serve as a guide for healthcare professionals, helping them to address individual‐ and family‐focused needs in an integrated manner. There have been several models and theories put forward in the literature related to the self‐management of chronic diseases, as well as an increasing amount of evidence of improved health outcomes with interventions (Casida et al, 2018; Novak et al, 2013; Ryan & Sawin, 2009). Among these theories, the Individual and Family Self‐Management Theory (IFSMT) developed by Ryan and Sawin in 2009, focusses on adolescents with chronic diseases and their families, with particular focus on the proximal and distal outcomes of individuals.…”

Effect of Ventricular Assist Device Self-care Simulation-Based Mastery Learning on Driveline Exit Site Infections

“…Nationally, the 12-month DLES infection rate approaches 20%, which partially accounts for the post-VAD implantation 30-day readmission rate of approximately 30%. [8][9][10] Strategies to reduce DLES infections include improved surgical techniques, anchoring devices to reduce trauma, and driveline self-care education. 11 However, VAD self-care training is highly variable due to time, availability, and lack of standardization.…”

“…Thus, maintaining a sterile dressing at the DLES is important to prevent infection. Nationally, the 12-month DLES infection rate approaches 20%, which partially accounts for the post–VAD implantation 30-day readmission rate of approximately 30% 8–10 . Strategies to reduce DLES infections include improved surgical techniques, anchoring devices to reduce trauma, and driveline self-care education 11 .…”