Home care challenges and adaptive capacity in patients with left ventricular assist devices: an evidence-informed qualitative study

Objective To identify post-discharge home care challenges and adaptive capacities among patients with left ventricular assist devices (LVADs), and to inform strategies for optimizing transitional care and long-term heart failure management in the Chinese healthcare context. Methods A two-phase, evidence-informed qualitative design was employed. In phase one, a structured literature review of six databases was conducted, and eight relevant studies were synthesized to inform the development of a semi-structured interview guide. In phase two, in-depth telephone interviews were conducted with 13 patients during home-based rehabilitation following LVAD implantation. Interview data were analyzed using reflexive thematic analysis. Results Based on the interview data, 52 sub-codes were identified and organized into 29 care need themes across four domains: self-management, medical care, device management, and social support. Key needs included emotional and family support, standardized device and wound care, emergency preparedness, rehabilitation guidance, medical accessibility, battery management, and financial or caregiving resource support. Participants also demonstrated situated adaptive capacity in managing device-related and home-care demands. Conclusion Patients with LVADs face substantial post-discharge home management challenges, while vulnerability and adaptive capacity coexist during recovery. These findings support a context-sensitive, patient-centered transitional care approach that strengthens self-management, caregiver involvement, device adaptation, and continuity of care in heart failure pathways.