Evidence map›Paper›PMID 34308687›Full record

ArticleJournal of the American Heart Association2021

Perceptions of Bereaved Caregivers and Clinicians About End-of-Life Care for Patients With Destination Therapy Left Ventricular Assist Devices.

Sarah Chuzi, Adeboye Ogunseitan, Kenzie A Cameron, Kathleen Grady, Lauren Schulze, Jane E Wilcox

Open access · goldAbstract read
In one paragraph

Article in Journal of the American Heart Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.8field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 13 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Sarah ChuziDivision of Cardiology Department of Medicine Feinberg School of Medicine Northwestern University Chicago IL.
Adeboye OgunseitanDivision of Hospital Medicine (Palliative Care) Department of Medicine Feinberg School of Medicine Northwestern University Chicago IL.
Kenzie A CameronDivision of General Internal Medicine and Geriatrics Department of Medicine Feinberg School of Medicine Northwestern University Chicago IL.
Kathleen GradyDivision of Cardiology Department of Medicine Feinberg School of Medicine Northwestern University Chicago IL.
Lauren SchulzeDivision of Cardiac Surgery Department of Surgery Feinberg School of Medicine Northwestern University Chicago IL.
Jane E WilcoxDivision of Cardiology Department of Medicine Feinberg School of Medicine Northwestern University Chicago IL.
Northwestern University · US

Funding

Northwestern University Clinical and Translational Science Institute (NUCATS)UL1TR001422 · NCATS · NORTHWESTERN UNIVERSITY AT CHICAGO · PI D'AQUILA, RICHARD · 2015 to 2023
$56.8M
NCATS NIH HHS UL1 TR001422
6 · The paper itself

Abstract

Background Patients with left ventricular assist devices (LVADs) implanted as destination therapy may receive suboptimal preparation for and care at the end of life, but there is limited understanding of the reasons for these shortcomings. Exploring perceptions of individuals (caregivers and clinicians) who are closely involved in the end-of-life experience with patients with destination therapy LVADs can help identify key opportunities for improving care. Methods and Results We conducted semistructured qualitative interviews with 7 bereaved caregivers of patients with destination therapy LVADs and 10 interdisciplinary LVAD clinicians. Interviews explored perceptions of preparing for end of life, communicating about end of life, and providing and receiving end-of-life care, and were analyzed using a 2-step team-based inductive approach to coding and analysis. Six themes pertaining to end-of-life experiences were derived: (1) timing end-of-life discussions in the setting of unpredictable illness trajectories, (2) prioritizing end-of-life preparation and decision-making, (3) communicating uncertainty while providing support and hope, (4) lack of consensus on responsibility for end-of-life discussions, (5) perception of the LVAD team as invincible, and (6) divergent perceptions of LVAD withdrawal. Conclusions This study revealed 6 unique aspects of end-of-life care for patients with destination therapy LVADs as reported by clinicians and caregivers. Themes coalesced around communication, team-based care, and challenges unique to patients with LVADs at end of life. Programmatic changes may address some aspects, including training clinicians in LVAD-specific communication skills. Other aspects, such as standardizing the role of the palliative care team and developing practical interventions that enable timely advance care planning during LVAD care, will require multifaceted interventions.

Indexed as

Heart-Assist DevicesHeart FailureQuality of LifeSocial PerceptionTerminal CareAdvance Care PlanningAttitude of Health PersonnelCaregiversFemaleHealth Services Needs and DemandHospice CareHumansMaleMiddle AgedPalliative CarePatient Care Teamend‐of‐life carepalliative careventricular assist device

Identifiers

PMID34308687
PMCPMC8475670
OpenAlexW3185680156

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.