Plan d’intervention visant à soutenir le processus décisionnel concernant l’implantation d’un dispositif d’assistance ventriculaire auprès des patients vivant avec l’insuffisance cardiaque avancée et leur famille
The offer of a ventricular assist device (VAD) involves complex choices and informed decision. The decision-making support in this context requires nursing practice skills to promote better patient outcomes. This project aimed to co-develop and pilot an intervention plan to support shared decision-making (SDM) for patients considering a VAD, their caregivers and the multidisciplinary healthcare team. The project involved a focus group for patients and caregivers to explore their decision-making needs, regular team meetings, a workshop for professionals on SDM approach and clarification of professional values, and the creation of a decision aid based on these needs. The focus group’s main results revealed patient’s needs to better understand their life trajectory with, or without, a VAD, caregiver’ needs for better stress management, and the need for better resource accessibility. Regular team meetings aimed to inform and to collect comments to insure feasibility and sustainability of the project. The SDM workshop aimed to increase competence toward this approach and the use of the decision aid tool. The resulting decision aid answered the team’s initial needs for informational support, decisional process standardization and optimization of information exchange. An algorithm was developed to help patients and families reflect on their treatment options according to their values and life objectives. This project is timely relevant given the increase in VAD implantation in Canada. The intervention could also be applicable to other decision-making situations in which active patient and family participation can improve the quality of the process.
Heart failure Ventricular assist device Shared decision-making Decision aid