A Thematic Qualitative Synthesis on the Lived Experiences of Patients With Left Ventricular Assist Devices: A Journey From Vulnerability to Resilience.

Abstract

<h4>Background</h4>Left ventricular assist devices (LVADs) are increasingly used in managing advanced heart failure. While their clinical benefits are well documented, less is known about how patients experience living with such life-sustaining devices. Understanding these experiences is essential for holistic, person-centred nursing care.<h4>Aim</h4>To explore the lived experiences of LVAD recipients and examine how they cope with the emotional, psychological and social challenges of life with an LVAD.<h4>Study design</h4>A systematic search was conducted across Scopus, PubMed and ScienceDirect using predefined terms. The retrieved studies were reviewed and subjected to qualitative synthesis according to Thomas and Harden's methodology. Screening was performed in Covidence, critical appraisal utilised CASP criteria, coding was carried out in ATLAS.ti, and reporting followed ENTREQ guidelines.<h4>Findings</h4>Sixteen qualitative studies published between 2010 and 2024 were reviewed. Four analytical themes were identified: (1) Loss: The Failing Body, Stigma, and the Others, (2) Living with Fear and Uncertainty: And Now What? (3) Liminality: Stagnating Present and Ambivalence and (4) Moving Forward and Finding New Meaning in Life. These reflect a psychological and existential journey from vulnerability to resilience, aligning with Lazarus and Folkman's Transactional Model of Stress and Coping.<h4>Conclusions</h4>The synthesis offers novel insights into how LVAD patients cope with complex challenges and highlights underexplored domains such as stigma, identity disruption and meaning-making.<h4>Relevance to clinical practice</h4>Findings underscore the need for holistic, continuous care strategies that support both the technological and psychosocial adaptation of LVAD patients, beginning in the intensive care unit. ICU nurses are pivotal in initiating recovery by providing early psychological support, fostering patient empowerment and preparing individuals and their families for life after critical illness. Addressing emotional instability, identity disruption and fear during ICU admission and early discharge planning can promote resilience and smoother transitions. This review highlights the crucial role of ICU nurses not only in acute care delivery but also in shaping long-term coping trajectories. Applying the Transactional Model of Stress and Coping offers a novel lens for guiding these interventions across the critical care continuum.