Left Ventricular Assist Device Caregiver Experiences and Health Outcomes: A Systematic Review of Qualitative and Quantitative Studies.
Abstract Background Knowledge synthesis is lacking regarding outcomes and experiences of caregivers of adult patients living with continuous flow left ventricular assist devices (CF-LVAD). The purpose of this systematic review is to summarize qualitative data related to the experience of caregivers of adult patients living with CF-LVAD as well as quantitative data related to health outcomes of caregivers. Methods and Results Multiple databases were systematically queried for studies of qualitative experiences and quantitative health outcomes for caregivers of adult CF-LVAD recipients. Search dates were constrained to articles published between 2004 and August of 2018 as CF-LVADs were not routinely implanted prior to 2004. Two authors independently screened 683 articles; 15 met pre-determined inclusion criteria. Eligible articles reported results from 13 studies. Of those, 8 used either qualitative or mixed-methods and 5 used quantitative methods. Caregivers were primarily female (81%) and mean age was 59 years. Qualitative studies revealed 3 overarching themes related to the caregiver role, coping strategies, and LVAD decisions. Quantitative studies revealed caregiver strain peaked between 1 to 3 months post-implant, anxiety and depression were relatively stable, mental health status improved, and physical health status was stable from pre- to post-implant. Conclusion CF-LVAD caregivers experience significant, sustained emotional strain for 3 months following implantation, reporting considerable stress in meeting their personal needs and those of their loved one.