Edinburgh Napier University

  BACKGROUND: Vascular Access Devices (VAD) are essential for the delivery of intravenous therapies. As patients often live with these devices in place for many months, it is important to understand how patients with cancer make sense of living with these devices.
AIM: To explore, in-depth, the lived experience of patients with a Vascular Access Device (VAD).
DESIGN / METHODS: This study followed a qualitative approach using Interpretive Phenomenological Analysis (IPA) principles. A purposive sampling technique was used to identify eleven patients with cancer who had a vascular access device in situ and were willing to share their experiences. Semi-structured interviews were the data collection tool. Interviews were digitally recorded, transcribed, and analysed using IPA principles.
FINDINGS: Four superordinate themes emerged from the interview data: The self under attack; Being rescued / Being robbed; Protection of self / Protection of others; and Bewilderment and dismay at the lack of staff competence. The study discovered that the insertion of a long-term VAD changes the self and affects the psychological, social, and personal self and impacts on self-esteem and self-image. The insertion of a VAD results in restrictions and limitations to life and can lead to living with distrust and fear. Despite this, VADs are accepted and are eventually embodied. These findings add to existing knowledge by developing the meaning of living with a VAD. To illuminate this understanding and articulate the new knowledge, a conceptual framework entitled the Vicious Cycle of Vascular Access was developed.
DISCUSSION: When the decision is made to insert a long-term VAD, both the body and mind should be considered. Steps should be taken to improve the lives of people living with a VAD through improved education and training for Health Care Professionals and by increasing support for people with VAD.