左心室辅助装置植入患者及其照顾者二元疾病管理影响因素及干预策略研究进展

doi:10.3761/j.issn.2096-7446.2025.12.009

摘要/Abstract

摘要：

二元疾病管理是指将患者及其照顾者作为相互依赖的整体，共同管理疾病。左心室辅助装置植入已成为心力衰竭患者等待心脏移植过渡治疗或心肌功能恢复的替代性治疗手段，但其术后复杂的日常疾病管理及并发症给患者及其照顾者带来较大压力。该文对左心室辅助装置植入患者及照顾者二元参与疾病决策、管理日常健康行为、情感支持影响因素及二元疾病管理干预措施现状进行综述，以期提高护理人员对其二元应对关注度，为实施全面疾病照护需求及制订二元应对干预措施提供参考。

关键词: 心脏辅助装置, 二元应对, 照顾者, 危重病护理, 综述文献专题

Abstract:

Dyadic disease management refers to treating the patient and their caregiver as an interdependent unit，jointly managing the disease. Left ventricular assist device implantation has become an alternative treatment for heart failure patients awaiting heart transplantation or for myocardial functional recovery. However，the complex daily disease management and postoperative complications impose significant burdens on both patients and their caregivers. This article reviews the current status of factors influencing dyadic involvement in disease decision-making，managing daily health behaviors，and emotional support for left ventricular assist device recipients and their caregivers，as well as existing dyadic disease management interventions. The aim is to enhance clinical nursing staff’s awareness of dyadic coping，provide insights for addressing comprehensive care needs，and inform the development of dyadic coping intervention strategies.

Key words: Heart-Assist Devices, Dyadic Coping, Caregiver, Critical Care Nursing, Review Literature as Topic

刘丹丹, 王婷, 刘欢, 孙君香. 左心室辅助装置植入患者及其照顾者二元疾病管理影响因素及干预策略研究进展[J]. 中华急危重症护理杂志, 2025, 6(12): 1462-1465.

LIU Dandan, WANG Ting, LIU Huan, SUN Junxiang. Research progress on influencing factors and intervention strategies for dyadic disease management in patients with left ventricular assist devices and their caregivers[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(12): 1462-1465.

参考文献 24

[1]	Darling CE, Martindale JL, Hiestand BC, et al. An emergency medicine-focused summary of the HFSA/SAEM/ISHLT clinical consensus document on the emergency management of patients with ventricular assist devices[J]. Acad Emerg Med, 2020, 27(7):618-629. doi: 10.1111/acem.13964 pmid: 32176420
[2]	胡盛寿, 王现强, 周星彤. 心室辅助装置治疗心力衰竭:现状和下一步思考[J]. 中国循环杂志, 2023, 38(8):791-793.
	Hu SS, Wang XQ, Zhou XT. Ventricular assist devices for the treatment of heart failure:current state and future prospects[J]. Chin Circ J, 2023, 38(8):791-793.
[3]	Zaloznik Djordjevic J, Özkan T, Göncz E, et al. Common complications and cardiopulmonary resuscitation in patients with left ventricular assist devices:a narrative review[J]. Medicina, 2023, 59(11):1981. doi: 10.3390/medicina59111981
[4]	Lyons KS, Lee CS. The theory of dyadic illness management[J]. J Fam Nurs, 2018, 24(1):8-28. doi: 10.1177/1074840717745669 pmid: 29353528
[5]	Rusbult CE, Van Lange PAM. Interdependence,interaction,and relationships[J]. Annu Rev Psychol, 2003,54:351-375.
[6]	Warraich HJ, Allen LA, Blue LJ, et al. Comorbidities and the decision to undergo or forego destination therapy left ventricular assist device implantation:an analysis from the Trial of a Shared Decision Support Intervention for Patients and their Caregivers Offered Destination Therapy for End-Stage Heart Failure(DECIDE-LVAD) study[J]. Am Heart J, 2019,213:91-96.
[7]	Kim JM, Maqsood MH, Makuvire T, et al. Gender-based differences in decision making,quality of life and survival among patients undergoing left ventricular assist device evaluation[J]. PLoS One, 2023, 18(10):e0293121. doi: 10.1371/journal.pone.0293121
[8]	Golan M, Vilchinsky N, Wolf H, et al. Couples’ coping strategies with left ventricular assist device implantation:a qualitative dyadic study[J]. Qual Health Res, 2023, 33(8/9):741-752. doi: 10.1177/10497323231168580
[9]	Dillworth J, Dickson VV, Reyentovich A, et al. Patient decision-making regarding left ventricular assist devices:a multiple case study[J]. Intensive Crit Care Nurs, 2019,51:7-14.
[10]	Kugler C, Spielmann H, Seemann M, et al. Self-management for patients on ventricular assist device support:a national,multicentre study:protocol for a 3-phase study[J]. BMJ Open, 2021, 11(5):e044374. doi: 10.1136/bmjopen-2020-044374
[11]	Mornese Pinna S, Corcione S, Cavallone E, et al. Epidemiology and risk factors for nosocomial infections in left ventricular assist device recipients[J]. Life, 2024, 14(2):270. doi: 10.3390/life14020270
[12]	McIlvennan CK, Jones J, Makic M, et al. Stress and coping among family caregivers of patients with a destination therapy left ventricular assist device:a multicenter mixed methods study[J]. Circ Heart Fail, 2021, 14(10):e008243. doi: 10.1161/CIRCHEARTFAILURE.120.008243
[13]	李飞, 张小敏, 陈娟. 左心室辅助装置植入术后患者及其主要照护者居家照护需求的质性研究[J]. 实用心脑肺血管病杂志, 2024, 32(6):112-116.
	Li F, Zhang XM, Chen J. Home care needs of patients and their primary caregivers after left ventricular assist device implantation:a qualitative study[J]. Pract J Card Cereb Pneumal Vasc Dis, 2024, 32(6):112-116.
[14]	Casida JM, Pavol M, Craddock H, et al. Patient-reported issues following left ventricular assist device implantation hospitalization[J]. ASAIO J, 2021, 67(6):658-665. doi: 10.1097/MAT.0000000000001381 pmid: 33587467
[15]	Streur MM, Auld JP, Liberato ACS, et al. Left ventricular assist device caregiver experiences and health outcomes:a systematic review of qualitative and quantitative studies[J]. J Card Fail, 2020, 26(8):713-726. doi: S1071-9164(19)31611-2 pmid: 32505816
[16]	Bidwell JT, Lyons KS, Mudd JO, et al. Patient and caregiver determinants of patient quality of life and caregiver strain in left ventricular assist device therapy[J]. J Am Heart Assoc, 2018, 7(6):e008080. doi: 10.1161/JAHA.117.008080
[17]	Kormos RL, Cowger J, Pagani FD, et al. The Society of Thoracic Surgeons Intermacs database annual report:Evolving indications,outcomes,and scientific partnerships[J]. J Heart Lung Transplant, 2019, 38(2):114-126. doi: 10.1016/j.healun.2018.11.013
[18]	Olt CK, Thuita LW, Soltesz EG, et al. Value of psychosocial evaluation for left ventricular assist device candidates[J]. J Tho-rac Cardiovasc Surg, 2023, 165(3):1111-1121.e12.
[19]	Thomas M, Spertus JA, Andrei AC, et al. Association between caregiver burden and patient recovery after left ventricular assist device implantation:insights from sustaining quality of life of the aged:heart transplant or mechanical support[J]. J Cardiovasc Nurs, 2023, 38(3):237-246. doi: 10.1097/JCN.0000000000000972
[20]	黎万汇, 岳雯静, 王子涵, 等. 左心室辅助装置植入患者生活体验质性研究的Meta整合[J]. 中华护理杂志, 2023, 58(10):1261-1268. doi: 10.3761/j.issn.0254-1769.2023.10.017
	Li WH, Yue WJ, Wang ZH, et al. A systematic Meta-synthesis of qualitative research on life experience of patients with left ventricular assist device implantation[J]. Chin J Nurs, 2023, 58(10):1261-1268. doi: 10.3761/j.issn.0254-1769.2023.10.017
[21]	何晓娣, 兰美娟, 陈媛儿, 等. 左心室辅助装置植入患者围手术期行家庭参与式护理的实践[J]. 中华急危重症护理杂志, 2024, 5(8):721-724.
	He XD, Lan MJ, Chen YE, et al. Practice of family integrated perioperative care for patients with implanted left ventricular assist devices[J]. Chin J Emerg Crit Care Nurs, 2024, 5(8):721-724.
[22]	Patel SK, Luke A, Schutt A, et al. Evaluation of a novel vir-tual care platform for remote monitoring of LVAD patients[J]. J Heart Lung Transplant, 2022, 41(5):558-562. doi: 10.1016/j.healun.2022.02.005
[23]	彭斯, 张霞, 周林, 等. 1例行左心室辅助装置植入联合冷冻消融术患者的护理[J]. 中华护理杂志, 2024, 59(22):2785-2789. doi: 10.3761/j.issn.0254-1769.2024.22.015
	Peng S, Zhang X, Zhou L, et al. Perioperative care of a patient implanted left ventricular assist device combined with cryoablation[J]. Chin J Nurs, 2024, 59(22):2785-2789. doi: 10.3761/j.issn.0254-1769.2024.22.015
[24]	马艳, 吴荣, 张辰, 等. 左心室辅助装置植入患者术后护理专家共识[J]. 中华护理杂志, 2024, 59(14):1687-1690.
	Ma Y, Wu R, Zhang C, et al. Expert consensus on postoperative care of patients with a left ventricular assistant device[J]. Chin J Nurs, 2024, 59(14):1687-1690.