‘Being’ a ventricular assist device recipient: A liminal existence

Abstract

Ventricular assist devices (VADs) are playing an increasing role in the management of heart failure. VADs are mechanical circulatory devices that support or replace the function of a failing heart. Currently, VADs are only offered in theUnited Kingdom (UK) to patients waiting for a heart transplant; however, the use of these devices is likely to increase in the near future. Presently, there is a dearth of literature exploring the day-to-day realities of living with a VAD, which will become increasingly important as the role of VADs is increased. This paper adopts an interpretive phenomenological approach to uncover the experience of 'Being' a VAD recipient. Semi-structured interviews were conducted with 20 VAD recipients. The overarching theme is that life with a VAD is a liminal existence. This comprised four subthemes: the first examines how the VAD imposes limitations on recipients' lives that can precipitate a loss of identity; the second focuses on temporal disruptions, recipients' sense of time changes from authentic to inauthentic; the third explores how the VAD itself is liminal, it is positioned as temporary rather than as the 'answer' to the condition; and finally, we discuss VAD recipients' projections to the future and the possibility of an end to the experience of liminality.

Young adult patients’ experience of living with mechanical circulatory support: A phenomenological hermeneutical study

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“…Some concepts such as biographical abruption (Locock, Ziebland, & Dumelow, 2009) are specific to conditions deemed terminal, such as MND, as they represent a 'breaking off' of lifethe sense of living death. A life over but not over are indicative of a 'liminal state', the ambiguous sense of being 'betwixt and between' different states (Standing, Rapley, Macgowan, & Exley, 2017). 'Knowing that time is limited, but not how the disease will progress, is like stepping into an unpredictable space where the path forward is uncertain' (Ellingsen, Roxberg, Kristoffersen, Rosland, & Alvsvag, 2014).…”