19. After you left the hospital, did you go directly to your own home, to someone else’s home, or to another health facility?
1. Own home
2. Someone else’s home
3. Another health facility If Another, GO TO QUESTION 30
20. During the hospital stay after your VAD surgery, did doctors, nurses or other hospital staff talk with you about whether you would have the help you needed when you left the hospital?
1. Yes 2. No
174
21. During the hospital stay after your VAD surgery, did doctors, nurses or other hospital staff talk with you about the help you needed when you left the hospital as soon as you wanted?
1. Yes 2. No
22. During the hospital stay after your VAD surgery, did doctors, nurses or other hospital staff talk with you about the help you needed when you left the hospital as thoroughly as you wanted?
1. Yes 2. No
23. During the hospital stay after your VAD surgery, was the discussion about the help you needed when you left the hospital individualized to your needs and preferences?
1. Yes 2. No
24. How important was it to you that doctors, nurses or other hospital staff talk with you about the help you needed when you left the hospital?
1. Not at all important 2. Somewhat important 3. Important
4. Very Important
25. During the hospital stay after your VAD surgery, did you get information in writing about what symptoms or health problems to look out for after you left the hospital?
1. Yes 2. No
26. During the hospital stay after your VAD surgery, did you get information in writing about what symptoms or health problems to look out for after you left the hospital as soon as you wanted?
1. Yes 2. No
175
27. During the hospital stay after your VAD surgery, was information in writing about what symptoms or health problems to look out for after you left the hospital as thorough as you wanted?
1. Yes 2. No
28. During the hospital stay after your VAD surgery, was information in writing about what symptoms or health problems to look out for after you left the hospital
individualized to your needs and preferences?
1. Yes 2. No
29. How important was it to you that you got information in writing about what problems or symptoms to look out for after you left the hospital?
1. Not at all important 2. Somewhat important 3. Important
4. Very Important
30. Did you get information in writing about how to properly assess and perform VAD exit site care? (If NO, GO TO QUESTION ; IF YES, GO TO QUESTION )
1. Yes 2. No
31. How was information about how to properly assess and perform VAD exit site care provided to you?
__________________________
32. Was information provided about how to properly assess and perform VAD exit site care as soon as you wanted?
1. Yes 2. No
176
33. Was information provided about how to properly assess and perform exit site care as thorough as you wanted?
1. Yes 2. No
34. Was information provided about how to properly assess and perform exit site care individualized to your needs and preferences?
1. Yes 2. No
35. How important was it to you to receive information about how to properly assess and perform VAD exit site care?
1. Not at all important 2. Somewhat important 3. Important
4. Very Important
36. Did you get information in writing about how to transfer VAD power source from wall to battery for mobility? (If NO, Go to QUESTION ; If YES, go to QUESTION )
1. Yes 2. No
37. How was information about how to transfer VAD power source from wall to battery for mobility provided to you?
_____________________
38. Did you get information about how to transfer VAD power source from wall to battery for mobility as soon as you wanted?
1. Yes 2. No
39. Was information provided about how to transfer VAD power source from wall to battery for mobility as thorough as you wanted?
1. Yes 2. No
177
40. Was information provided about how to transfer VAD power source from wall to battery for mobility individualized to your needs and preferences?
1. Yes 2. No
41. How important was it to you to receive information about how to transfer VAD power source from wall to battery for mobility?
1. Not at all important 2. Somewhat important 3. Important
4. Very Important
42. Did you get information in writing about what to do in case of a VAD emergency? (If NO, go to QUESTION . If YES, go to QUESTION )
o Yes o No
43. How was information about what to do in case of a VAD emergency provided?
_____________________
44. Did you get information about what to do in case of a VAD emergency as soon as you wanted?
1. Yes 2. No
45. Was information provided about what to do in case of a VAD emergency as thorough as you wanted?
1. Yes 2. No
46. Was information provided about what to do in case of a VAD emergency individualized to your needs and preferences?
1. Yes 2. No
178
47. How important was it to you to receive information about what to do in case of a VAD emergency?
Not at all important Somewhat important Important
Very Important
48. Using any number from 0 to 10, where 0 is the worst hospital possible and 10 is the best hospital possible, what number would you use to rate this hospital during your stay?
1 (worst hospital possible)
2
3
4
5
6
7
8
9
10 (best hospital possible) V. Information About You 49. Age - ________ years 50. Gender
1. Male 2. Female 51. Race
1. American Indian/Alaska Native 2. Asian
3. Native Hawaiian/Pacific Islander 4. Black/African American
5. White 52. Ethnicity
1. Hispanic/Latino 2. Not Hispanic/Latino
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53. Educational Level 1. Some high school 2. High School/GED 3. Some college 4. Undergraduate 5. Graduate
54. Income Level (annual) 1. < $20,000
2. $25,000 – $50,000 3. $50,000 - $75,000 4. > $75,000
55. Marital Status
1. Married/Marriage-like relationship 2. Widowed
3. Divorced 4. Single
56. What type of VAD system did you receive?
1. Heartmate II 2. Hearmate XVE
3. Thoratec TLC II (BiVAD) 4. Other
5. Don’t know
57. How long have you had your VAD device?
1. < 1 month 2. 1-3 months 3. 3-6 months 4. 6-12 months 5. > 12 months