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Identifying Knowledge Gaps among LVAD Candidates

1
Center for Medical Ethics and Health Policy, Baylor College of Medicine, One Baylor Plaza, Suite 310D, Houston, TX 77030, USA
2
Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Ave. J3-4, Cleveland, OH 44195, USA
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(4), 549; https://doi.org/10.3390/jcm8040549
Received: 31 March 2019 / Revised: 18 April 2019 / Accepted: 22 April 2019 / Published: 23 April 2019
(This article belongs to the Special Issue Clinical Use of Left Ventricular Assist Devices)
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Abstract

Education is an important aspect of evaluation and consent for left ventricular assist device (LVAD) candidates. A better understanding of candidate knowledge during the education process can help identify knowledge gaps and improve informed consent processes. This paper presents the results from a validated, LVAD-specific Knowledge Scale administered to candidates before and after education to identify items most and least frequently answered correctly. At baseline and 1-week, both candidates educated with a standard education and an LVAD-specific decision aid were most likely to answer logistical items relating to support and self-care correctly with ≥90% of candidates answering these items correctly after education. Candidates were least likely to answer questions about risks, transplant eligibility, and expenses correctly with <60% of candidates answering them correctly after education. Items with the greatest improvement in correct answers from baseline to 1-week were primarily related to the logistics of living with an LVAD. Candidates educated with the decision aid showed significant improvements on more knowledge items including those related to the forecasting of recovery and complications when compared to candidates educated with a standard education. The 20-item scale provides a standardized way for clinicians to identify knowledge gaps with LVAD candidates, potentially helping to tailor education. Targeted improvements in LVAD education should focus on the understanding of risk and potential complications to ensure that decision-making and informed consent processes emphasize both the patient and clinicians’ conceptualizations of knowledge needs for informed consent. View Full-Text
Keywords: ventricular assist device; mechanical circulatory support; heart failure; education; consent; knowledge ventricular assist device; mechanical circulatory support; heart failure; education; consent; knowledge
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Buchberg Trejo, M.; Kostick, K.M.; Estep, J.D.; Blumenthal-Barby, J. Identifying Knowledge Gaps among LVAD Candidates. J. Clin. Med. 2019, 8, 549.

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