Examining the Real‐Life Journey of Individuals and Families Affected by Single‐Ventricle Congenital Heart Disease

Author:

Mery Carlos M.12ORCID,Well Andrew123ORCID,Taylor Kate12ORCID,Carberry Kathleen3,Colucci José4ORCID,Ulack Christopher3,Zeiner Adam4,Mizrahi Michelle12ORCID,Stewart Eileen15,Dillingham Christine1ORCID,Cook Taylor4,Hartounian Arotin4ORCID,McCullum Elizabeth12,Affolter Jeremy T.15ORCID,Van Diest Heather16ORCID,Lamari‐Fisher Alexandra17,Chang Stacey4,Wallace Scott3ORCID,Teisberg Elizabeth3ORCID,Fraser Charles D.12

Affiliation:

1. Texas Center for Pediatric and Congenital Heart Disease UT Health Austin/Dell Children’s Medical Center Austin TX

2. Department of Surgery and Perioperative Care The University of Texas at Austin Dell Medical School Austin TX

3. Value Institute for Health and Care The University of Texas at Austin Dell Medical School and McCombs School of Business Austin TX

4. Design Institute for Health The University of Texas at Austin Dell Medical School and College of Fine Arts Austin TX

5. Department of Pediatrics The University of Texas at Austin Dell Medical School Austin TX

6. Department of Health Social Work The University of Texas at Austin Dell Medical School Austin TX

7. Department of Psychiatry and Behavioral Sciences The University of Texas at Austin Dell Medical School Austin TX

Abstract

Background The lifetime journey of patients with single‐ventricle congenital heart disease is characterized by long‐term challenges that are incompletely understood and still unfolding. Health care redesign requires a thorough understanding of this journey to create and implement solutions that improve outcomes. This study maps the lifetime journey of individuals with single‐ventricle congenital heart disease and their families, identifies the most meaningful outcomes to them, and defines significant challenges in the journey. Methods and Results This qualitative research study involved experience group sessions and 1:1 interviews of patients, parents, siblings, partners, and stakeholders. Journey maps were created. The most meaningful outcomes to patients and parents and significant gaps in care were identified across the life journey. A total of 142 participants from 79 families and 28 stakeholders were included. Lifelong and life‐stage specific journey maps were created. The most meaningful outcomes to patients and parents were identified and categorized using a “ capability (doing the things in life you want to), comfort (experience of physical/emotional pain/distress), and calm (experiencing health care with the least impact on daily life) ” framework. Gaps in care were identified and classified into areas of ineffective communication, lack of seamless transitions, lack of comprehensive support, structural deficiencies, and insufficient education. Conclusions There are significant gaps in care during the lifelong journey of individuals with single‐ventricle congenital heart disease and their families. A thorough understanding of this journey is a critical first step in developing initiatives to redesign care around their needs and priorities. This approach can be used for people with other forms of congenital heart disease and other chronic conditions. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04613934.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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