Premium
Quality of Life and Emotional Distress Early After Left Ventricular Assist Device Implant: A Mixed‐Method Study
Author(s) -
Modica Maddalena,
Ferratini Maurizio,
Torri Anna,
Oliva Fabrizio,
Martinelli Luigi,
De Maria Renata,
Frigerio Maria
Publication year - 2015
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.12362
Subject(s) - anxiety , hospital anxiety and depression scale , quality of life (healthcare) , ventricular assist device , coping (psychology) , medicine , implant , heart failure , normative , distress , mental health , depression (economics) , physical therapy , clinical psychology , psychology , psychiatry , surgery , nursing , philosophy , epistemology , economics , macroeconomics
Patients who temporarily or permanently rely on left ventricular assist devices ( LVADs ) for end‐stage heart failure face complex psychological, emotional, and relational problems. We conducted a mixed‐method study to investigate quality of life, psychological symptoms, and emotional and cognitive reactions after LVAD implant. Twenty‐six patients admitted to cardiac rehabilitation were administered quality of life questionnaires ( S hort F orm 36 of the M edical O utcomes S tudy and M innesota L iving with H eart F ailure Q uestionnaire), the H ospital A nxiety and D epression S cale, and the C oping O rientation for P roblem E xperiences inventory, and underwent three in‐depth unstructured interviews within 2 months after LVAD implant. Quality of life assessment ( S hort F orm 36) documented persistently low physical scores whereas mental component scores almost achieved normative values. Clinically relevant depression and anxiety were observed in 18 and 18% of patients, respectively; avoidant coping scores correlated significantly with both depression and anxiety ( P earson correlation coefficients 0.732, P < 0.001 and 0.764, P < 0.001, respectively). From qualitative interviews, factors that impacted on LVAD acceptance included: device type, disease experience during transplant waiting, nature of the assisted organ, quality of patient–doctor communication, the opportunity of sharing the experience, and recipient's psychological characteristics. Quality of life improves early after LVAD implant, but emotional distress may remain high. A multidimensional approach that takes into account patients' psychological characteristics should be pursued to enhance LVAD acceptance.