Deactivation of Left Ventricular Assist Devices: Differing Perspectives of Cardiology and Hospice/Palliative Medicine Clinicians
| Autor: | Sara E. Wordingham, Larry A. Allen, Colleen K. McIlvennan, Daniel D. Matlock, Shannon M. Dunlay, Keith M. Swetz, Jacqueline Jones |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Palliative care Attitude of Health Personnel medicine.medical_treatment Cardiology 030204 cardiovascular system & hematology Electronic mail 03 medical and health sciences 0302 clinical medicine Physicians Surveys and Questionnaires Internal medicine medicine Humans 030212 general & internal medicine Palliative Medicine Intensive care medicine Heart Failure business.industry Hospices Middle Aged medicine.disease Hospice Care Ventricular assist device Heart failure Female Heart-Assist Devices Cardiology and Cardiovascular Medicine business End-of-life care |
| Zdroj: | Journal of Cardiac Failure. 23:708-712 |
| ISSN: | 1071-9164 |
| DOI: | 10.1016/j.cardfail.2016.12.001 |
| Popis: | Beliefs around deactivation of a left ventricular assist device (LVAD) vary substantially among clinicians, institutions, and patients. Therefore, we sought to understand perspectives regarding LVAD deactivation among cardiology and hospice/palliative medicine (HPM) clinicians.We administered a 41-item survey via electronic mail to members of 3 cardiology and 1 HPM professional societies. A convergent parallel mixed-methods design was used. From October through November 2011, 7168 individuals were sent the survey and 440 responded. Three domains emerged: (1) LVAD as a life-sustaining therapy; (2) complexities of the process of LVAD deactivation; and (3) legal and ethical considerations of LVAD deactivation. Most respondents (cardiology 92%; HPM 81%; P = .15) believed that an LVAD is a life-sustaining treatment for patients with advanced heart failure; however, 60% of cardiology vs 2% of HPM clinicians believed a patient should be imminently dying to deactivate an LVAD (P .001). Additionally, 87% of cardiology vs 100% of HPM clinicians believed the cause of death following LVAD deactivation was from underlying disease (P .001), with 13% of cardiology clinicians considering it to be a form of euthanasia or physician-assisted suicide.Cardiology and HPM clinicians have differing perspectives regarding LVAD deactivation. Bridging the gaps and engaging in dialog between these 2 specialties is a critical first step in creating a more cohesive approach to care for LVAD patients. |
| Databáze: | OpenAIRE |
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