Younger patient´s experience of living with mechanical circulatory support. A phenomenological-hermeneutic study

Abstract

Aims and objectives: To describe younger patients’ experiences of living with a mechanical circulatory support with focus on self-efficacy. Background: Heart failure is increasing even among younger patients. Life-threatening heart failure can occur and the patient will need heart transplantation. Treatment with mechanical circulatory support (MCS) may be necessary. Living with MCS in the form of a biventricular assist device (BiVAD) means living with a visible mechanical device attached to the body. There are no qualitative studies published describing only younger patients’ experiences of living with BiVAD, and how it affects their perception of their bodies. Self-efficacy plays a decisive role in dealing with threatening situations. It is important to gain in-depth knowledge of what BiVAD treatment means and how selfefficacy affects the patient’s ability to handle this life change. Design: A qualitative interview study with eight adults participants. Methods: The data was analyzed using the phenomenological-hermeneutic method. Results: An overall theme, Navigating from helplessness to feeling strong in the new reality, and three themes emerged: Feeling homeless in a changed reality describes the experience of suddenly falling ill and the loneliness caused by the disease. Finding my own inner resources shows that the interviewees found the strength to fight for their lives and began to regain control of their situation. Adapting to my new reality describes the importance of drawing strength from others and being able to see MCS as a friend providing respite from the disease. Conclusions: Self-efficacy belief plays a significant role for younger patients to be able to accept MCS treatment and to handle a changed reality. Relevance to clinical practice: When patients treated with MCS experience control over their situation, they can be transferred to a cardiology outpatient clinic, which for the patients imply a step towards independence and a sense of normality.