Development and validation of a patient-centered knowledge scale for left ventricular assist device placement

Area of Science:

• Cardiology
• Medical Device Technology
• Health Services Research

Background:

• Patient-centered care emphasizes informed decision-making, incorporating patient values, knowledge, and beliefs.
• Current validated measures for patient knowledge needs are lacking, hindering informed decision-making.
• Left Ventricular Assist Device (LVAD) therapy requires significant patient understanding for successful treatment.

Purpose of the Study:

• To develop a comprehensive and valid methodology for a patient-centered measure of knowledge about LVAD therapy.
• To facilitate informed decision-making by assessing candidate understanding of treatment options.
• To identify essential knowledge needs from the perspectives of patients, caregivers, and clinicians.

Main Methods:

• Structured interviews with 71 patients, caregivers, LVAD candidates (NYHA Class III/IV), and expert clinicians.
• Identification of top patient decisional needs and essential knowledge requirements.
• Generation of 20 knowledge scale items refined through cognitive interviews with 5 patients and consultants.

Main Results:

• The LVAD knowledge scale demonstrated good internal consistency and reliability (Cronbach's α = 0.81) in 30 LVAD patients and candidates.
• Patients currently with LVADs exhibited higher knowledge scores than candidates, even when controlling for standard education.
• Significant differences in knowledge were observed between LVAD patients and candidates, with and without standard education.

Conclusions:

• The LVAD knowledge scale can identify knowledge gaps in patients considering LVAD treatment.
• The scale can help tailor education and discussions for patients and caregivers to enhance informed decision-making.
• Improving patient knowledge is crucial for successful LVAD therapy and informed treatment choices.