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"We Don't Really Know Each Other": A Mixed Methods Study Exploring Patient-Clinician Values-Centered Discussions
Avery C Bechthold1, Rachel D Wells2, Colleen K McIlvennan3
1Avery C. Bechthold, PhD, RN, Assistant Professor, College of Nursing, University of Tennessee-Knoxville, Knoxville, Tennessee, USA.
The Journal of Cardiovascular Nursing
|February 6, 2026
Summary
Ventricular assist device (VAD) recipients value discussions about what matters most. Relational trust, emotional safety, and a supportive environment are crucial for these conversations.
Area of Science:
- Cardiovascular care
- Patient-centered outcomes
- Medical sociology
Background:
- High-quality cardiovascular care necessitates aligning treatments with patient values.
- Understanding values-centered discussions among ventricular assist device (VAD) recipients postimplantation is currently limited.
Purpose of the Study:
- To explore how VAD recipients engage in conversations to clarify their priorities.
- Investigate patient experiences and facilitators of values-centered discussions.
Main Methods:
- A sequential explanatory mixed-methods study was conducted.
- Adult VAD recipients completed surveys on values discussions, followed by semi-structured interviews for deeper insights.
Main Results:
- Survey data (N=32) and interviews (n=12) revealed key themes: relational trust, emotional safety, timing, readiness, and communication environment.
- Patients preferred trusted, approachable communicators and valued acceptance of their new reality.
- Negative experiences stemmed from frustration, conflict, and lack of understanding.
Conclusions:
- Relational trust, emotional readiness, and a supportive communication setting are vital for values-centered discussions.
- Nurses can foster these discussions by emphasizing continuity, accessibility, and emotional safety.
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