Type of Document Dissertation Author Widmar, Steve Brian URN etd-03182012-115729 Title Satisfaction with Patient-Centered Care and Self-Care Education in Left Ventricular Assist Device Patients Degree PhD Department Nursing Science Advisory Committee
Advisor Name Title Ann F. Minnick Committee Chair Kathleen L. Grady Committee Member Mary S. Dietrich Committee Member Michael W. Vollman Committee Member Keywords
- ventricular assist device
- heart failure
- heart transplantation
- self-care education
Date of Defense 2012-03-16 Availability unrestricted Abstract
SATISFACTION WITH PATIENT-CENTERED CARE AND SELF-CARE EDUCATION IN LEFT VENTRICULAR ASSIST DEVICE PATIENTS
STEVE BRIAN WIDMAR
Dissertation under the direction of Professor Ann F. Minnick
The study’s purposes were to: a) describe care structure and ventricular assist device (VAD) patient self-care education processes used in hospitals, and b) describe VAD patient reports of patient-centered care and satisfaction with care.
The study used a prospective cross-sectional design. AIM 1: A mailed 26-item survey, based on the Minnick and Roberts framework, was sent to all VAD centers in the United States (N = 111) in 2011. Two subsequent mailings with computer or paper completion options resulted in a return rate of 63% (n = 71). AIM 2: A 59-item survey, adapted from the Health Consumer Assessment of Healthcare Providers and Services (HCAHPS) survey and from Young & Minnick (1996), was completed via telephone with five patients receiving VAD therapy from one high-volume VAD hospital.
Programs varied in their use of Advanced Practice Nurses and VAD coordinator advanced practice inpatient nursing (p < .05). There was no standard method of providing postoperative VAD patient self-care education or evaluating self-care across hospitals. Most VAD programs (75%) used more than two resources in providing self-care education in addition to education materials provided by the VAD device manufacturer. Almost half of VAD programs (46%) used more than two methods of self-care evaluation for each skill set.
Patients were satisfied with patient-centered care and self-care education, and were grateful for regained independence and reduced heart failure symptoms. Patients reported uncertainty regarding their performance in emergencies. Preparation of local non-VAD hospitals to care for VAD patient health emergencies was identified as a need.
Further research is needed to explore relationships between VAD care processes and other outcomes such as survival and readmissions. Understanding the processes of self-care education and patient reports of patient-centered care after VAD implantation is necessary to improve VAD education and outcomes.
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