What Really Matters? Understanding Quality of Life Determinants Impacting Ventricular Assist Device Stakeholders.

Through the examination of digital channels, this study explores the determinants impacting the quality of life (QoL) of ventricular assist devices (VAD) stakeholders. Using nonparticipant online ethnography and qualitative content analysis, data were collected from 56 digital channels (Facebook, blogs, Forum, Instagram, YouTube, and podcasts) designed for VAD stakeholders. Data were classified across existing domains of QoL determinants to identify 12 new QoL determinants which address VAD stakeholders' specific needs. Inter-relationships between each stakeholder group's QoL determinants were also identified and explored through the VAD stakeholder QoL framework. This framework provides a holistic approach to the assessment of QoL by considering that QoL determinants are inter-related between stakeholder groups, whereby factors affecting a QoL determinant of one stakeholder can positively or negatively impact the same or other QoL determinants of other stakeholders. Further qualitative and longitudinal research with a focus on the various stages of the VAD patient journey is required to confirm our findings of QoL determinants and inter-relationship between VAD stakeholders from a holistic point of view and explore opportunities to support the QoL of all VAD stakeholders.

Human Factors and User Experience Issues with Ventricular Assist Device Wearable Components: A Systematic Review.

Ventricular Assist Devices (VADs) provide continuous mechanical circulatory support during in- and out-of-hospital care. However, limitations of the external wearable components influence patient quality of life. There is insufficient understanding of the issues with such components that combines a holistic viewpoint from both human factors and user (including patient and caregiver) experience perspectives. This paper comprehensively details the issues with VAD wearable systems and proposes a way for human-centered design to bridge the gap, addressing such issues synergistically. Through the review the authors investigated: the user issues caused by wearable components of VADs, and how human factors issues correlate to the VAD user experience. A Boolean search ("ventricular assist" AND "human factors" AND "experience") for peer-reviewed studies published between 2008 and 2018 returned 338 titles, with 35 relevant studies selected using a PRISMA process for inclusion in cross-study analysis and synthesis. This paper provides design recommendations for the issues found in the literature. Four key focus areas to inform the future design of VAD wearable components were identified-'Power Supply', 'Wearability and Travel Freedom', 'The Female Experience' and 'Intuitive Handling'. Using design to drive innovation could result in VAD wearable components which better meet or exceed users' quality of life goals.

A Comparative Content Analysis of Digital Channels for Ventricular Assist Device Patients, Caregivers, and Healthcare Practitioners.

This article seeks to review and analyze the emergence of digital channels designed for ventricular assist device (VAD) patients, caregivers, and practitioners and to understand how such digital channels support the user experience of VAD implantation. Following a content analysis methodology, the authors investigated 16 digital channels designed for VAD patients, caregivers, and practitioners, with data being analyzed thematically. Competitor Positioning Matrix diagrams were created to visually represent the landscape of digital channels that support VAD stakeholders. These matrices identified opportunities and potential areas for improvement in future VAD digital channel design, with an emphasis on interactivity coupled with intelligence and focus along the various stages of the VAD patient journey. Innovation in digital channels has the potential to reduce burden on all users by enabling communication, self-management, and remote monitoring. Digital channels can be information enhanced for point of care, function as a decision support tools or be used to empower patient-caregiver pairs to be more sufficient with self-management, while enabling communication with their practitioner.

Nursing Challenges in Interactions With Patients Receiving Mechanical Circulatory and Respiratory Support.

BACKGROUND: Mechanical circulatory and respiratory support (MCRS) systems provide short- to long-term life support for patients with severe cardiac or respiratory failure. Whereas the challenges of patients with these lifesaving systems are well understood, the challenges faced by nurses of patients receiving MCRS remain relatively unidentified. OBJECTIVES: In this study, we investigated the challenges and experiences of MCRS nurses, with the aim of informing the design of future interventions. DESIGN: A qualitative approach was taken to develop an in-depth understanding of the emotional issues nurses experience in their daily interactions with patients. PARTICIPANTS AND SETTING: Nine MCRS nurses ranging in clinical experience were recruited from Australian hospitals. METHODS: Participants were divided into 3 focus groups, with design prompts being used in the focus groups to facilitate discussion. Data from these focus groups were analyzed through a thematic analysis protocol. RESULTS: The nurses' accounts were clustered around 2 themes, including (1) patient connection and (2) compassion vitality and fatigue. Each theme elicits a conflicting compromise that MCRS nurses face daily. CONCLUSION: The challenges of nurses who support patients with MCRS are complex, multifaceted, emotionally stimulating, and exhausting. We therefore contributes a set of design criteria to support such nurses, setting a direction for future research.