Coping, Mood, Quality of Life, and Outcomes in Recipients of Left Ventricular Assist Devices

A Cluster Analysis

Bibliographic Data

ID19301577
AuthorsMaddalena Modica (Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda), Anna Minotti (Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda), Renata De Maria (0000-0002-8474-7923, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda), Anna Scaglione (0000-0002-8892-3680, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda), Bruno Bordoni (0000-0002-4949-5126, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda), Manlio Cipriani (0000-0002-0632-0561, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda), Claudio Russo (0000-0003-4877-2424, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda), Vittorio Racca (0000-0002-4465-3789, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda), Maurizio Ferratini (Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, corresponding author)
Year2019
Volume81
Issue2
Pages192-199
Publication date2019-02-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenuePsychosomatic Medicine (JOURNAL)
Journal identifiersISSN: 0033-3174 • E-ISSN: 1534-7796
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/psy.0000000000000658
PMID30625121
OpenAlexW2919904552
LanguageEN
References cited38

OBJECTIVE: Left ventricular assist devices (LVADs) are increasingly used for temporary circulatory support until transplant or as destination therapy for patients with end-stage heart failure. Understanding patients' attitudes and resources is crucial to support them. METHODS: Sixty-one LVAD recipients (55 [10] years, 10% women, 15% destination therapy) participating in cardiac rehabilitation (CR) postimplant underwent assessment of coping styles (Coping Orientation for Problem Experiences), quality of life (Medical Outcomes Study Short-Form 36, Minnesota Living with Heart Failure Questionnaire), and mood (Hospital Anxiety and Depression Scale). RESULTS: Cluster analysis identified two homogeneous groups: C1 (n = 18) patients had higher anxiety (9.6 [5.0] versus 4.0 [2.7], p < .001), depression (10 [3.0] versus 4 [2.7], p < .001), and avoidant coping (29 [5.2] versus 21.2 [3.8], p < .001) scores and worse quality of life (Short-Form 36 of the Medical Outcomes Study Physical Component Scale 31 [5.3] versus 35.6 [6.9], p < .001; Mental Component Scale 34.3 [6.8] versus 50.3 [8], p < .001; MLHFQ physical 26 [7.2] versus 13.9 [8.2], p < .001; emotional 17.7 [3.4] versus 3.86 [3.2], p < .001) than C2 participants (n = 43). During 31 (15-54) months, 20 patients (33%) died. By Cox multivariable analysis, after adjustment for age, sex, Interagency Registry for Mechanically Assisted Circulatory Support level at surgery, and meters walked during 6 minutes at CR discharge, C1 was associated with mortality (hazard ratio = 2.858; 95% confidence interval = 1.102-7.408, p = .031; model χ = 7.286, df = 5, p = .20). Survival was 44% in C1 and 77% in C2 (log-rank p = .033). CONCLUSIONS: Among patients discharged from CR after LVAD implant, one third show a profile characterized by worse perceived quality of life, mood disorders, and dysfunctional coping that is associated with long-term mortality, and these factors are potential targets for post-LVAD intensive support

Anxiety · Coping (psychology) · Destination therapy · Hazard ratio · Heart failure · Hospital Anxiety and Depression Scale · Mood · Physical therapy · Psychiatry · Quality of life (healthcare) · Ventricular assist device · Cardiac and Coronary Surgery Techniques · Clinical Psychology · Internal Medicine · Mechanical Circulatory Support Devices · Medicine · Nursing · Prosthetics and Rehabilitation Robotics

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