title: Living with a total artificial heart: patients' perspectives.
abstract: BACKGROUND
  Advances in mechanical circulatory support have reduced morbidity and mortality in end-stage heart failure. To date, there have been no published studies examining the psychosocial impact on patients who are supported with a total artificial heart (TAH-t).
  
  
  OBJECTIVE
  The purpose of this study was to describe the lived experience of patients currently supported by the TAH-t awaiting transplant.
  
  
  METHODS
  A qualitative method using Giorgi's modification of phenomenologic inquiry guided the investigation, which was conducted at a transplant center located in the mid-Atlantic region of the United States. A purposive sample was selected to reflect participants currently supported by the TAH-t. All participants (9 men, 1 woman; mean age, 48.2 years; nonischemic etiology, 80%) were in-patients on the progressive care unit at the time of the interview and had been supported for at least 30 days. The mean length of device therapy was 84.7 days (range, 33-245 days).
  
  
  RESULTS
  Hope for the future was the overarching theme. Subthemes included reflections, for better or for worse, the secret club, and coping and adaptation. The patients reflected on severity of illness, progress, and expressed optimism. For better or for worse described how symptoms improved but were offset by restrictions imposed by the technology. The secret club described the support provided to help deal with their life situation. Coping and adaptation suggested that the patients came to terms with and accepted their circumstances.
  
  
  CONCLUSIONS
  The findings will help clinicians understand patients experiencing a life-changing situation and implications for psychosocial interventions.
authors.affiliation: Laura S. Savage, RN, MSN, PCCN Transplant Coordinator, Heart Failure/Heart Transplant Program, Pauley Heart Center, Virginia Commonwealth University Health System, Richmond. Jeanne Salyer, PhD, RN Associate Professor, School of Nursing, Virginia Commonwealth University, Richmond. Maureen P. Flattery, RN, MS, ANP Transplant Coordinator, Heart Failure/Heart Transplant Program, Pauley Heart Center, Virginia Commonwealth University Health System, Richmond. Lucy Alburger, RN Staff Nurse, Pauley Heart Center, Virginia Commonwealth University Health System, Richmond. Kenna Joyce, RN, BSN, PCCN Clinical Coordinator, Pauley Heart Center, Virginia Commonwealth University Health System, Richmond. Barbara Mann, RN Staff Nurse, Pauley Heart Center, Virginia Commonwealth University Health System, Richmond. Malliga Ravindar, RN, MSN Staff Nurse, Pauley Heart Center, Virginia Commonwealth University Health System, Richmond. Maranatha Gonzalez, RN, MS Staff Nurse, Pauley Heart Center, Virginia Commonwealth University Health System, Richmond.
authors.forename: Laura S
authors.initials: LS
authors.lastname: Savage
authors.forename: Jeanne
authors.initials: J
authors.lastname: Salyer
authors.forename: Maureen P
authors.initials: MP
authors.lastname: Flattery
authors.forename: Lucy
authors.initials: L
authors.lastname: Alburger
authors.forename: Kenna
authors.initials: K
authors.lastname: Joyce
authors.forename: Barbara
authors.initials: B
authors.lastname: Mann
authors.forename: Malliga
authors.initials: M
authors.lastname: Ravindar
authors.forename: Maranatha
authors.initials: M
authors.lastname: Gonzalez
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D015400:Clinical Nursing Research; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D016027:Heart Transplantation; D006354:Heart, Artificial / Q000523:psychology; D065026:Hope; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D012944:Social Support