Kato Naoko P, Okada Ikuko, Kagami Yukie, Endo Miyoko, Hatano Masaru, Ono Minoru, Jaarsma Tiny, Kinugawa Koichiro
Department of Therapeutic Strategy for Heart Failure, The University of Tokyo Graduate School of Medicine, Tokyo, Japan; Department of Social and Welfare Studies, Faculty of Medicine and Health, Linköping University, Linköping, Sweden.
Department of Therapeutic Strategy for Heart Failure, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.
J Cardiol. 2018 Jan;71(1):81-87. doi: 10.1016/j.jjcc.2017.06.004. Epub 2017 Jul 31.
The role of caregivers is important for the successful support of left ventricular assist device (LVAD) patients. We aimed to (1) evaluate quality of life (QoL) of caregivers pre-and post-LVAD implant and (2) identify factors associated with caregivers' QoL.
The caregivers' QoL was assessed with the Short Form-8 before implant, at 3 and 6 months after LVAD implantation. The physical and mental component summary (PCS and MCS) scores were calculated. Caregiver burden was evaluated using the 8-item Zarit Caregiver Burden Interview.
Data were collected from LVAD patients as bridge-to-transplant and their family caregivers in Japan. No significant changes were found in caregivers' PCS scores during the follow-up (before 52.7±7.1; at 3 months 49.7±6.5, and at 6 months 50.7±6.4, n=20). Compared with the scores before implant (38.9±9.3), the caregivers' MCS scores improved after LVAD implantation at 3 months (44.2±7.7; p=0.03) and at 6 months (46.2±7.4, p=0.003), but they were still lower than those of the Japanese general population (p<0.01). In multiple regression analysis at 3 months (n=40), caregivers' lower PCS scores were associated with older patient age [standard partial regression coefficients (sβ)=-0.36, p=0.02] and caregiver unemployment (sβ=0.30, p=0.04), whereas being female (sβ=-0.26, p=0.03), being the patient's spouse (sβ=-0.23, p=0.03), and having a mild to moderate caregiving burden (sβ=-0.63, p<0.001) were associated with lower MCS scores among caregivers.
LVAD implantation improves caregivers' mental QoL. Since caregivers' MCS scores are lower than the general population, it is important to identify family caregivers at risk for low QoL and reduce their caregiving burden.
照顾者的角色对于成功支持左心室辅助装置（LVAD）患者至关重要。我们旨在（1）评估LVAD植入前后照顾者的生活质量（QoL），以及（2）确定与照顾者生活质量相关的因素。
在植入前、LVAD植入后3个月和6个月，使用简短健康调查问卷-8对照顾者的生活质量进行评估。计算身体和心理成分总结（PCS和MCS）得分。使用8项Zarit照顾者负担访谈评估照顾者负担。
收集了日本作为过渡到移植的LVAD患者及其家庭照顾者的数据。随访期间照顾者的PCS得分无显著变化（植入前52.7±7.1；3个月时49.7±6.5，6个月时50.7±6.4，n = 20）。与植入前的得分（38.9±9.3）相比，照顾者的MCS得分在LVAD植入后3个月（44.2±7.7；p = 0.03）和6个月（46.2±7.4，p = 0.003）有所改善，但仍低于日本普通人群（p<0.01）。在3个月时的多元回归分析中（n = 40），照顾者较低的PCS得分与患者年龄较大[标准偏回归系数（sβ）=-0.36，p = 0.02]和照顾者失业（sβ = 0.30，p = 0.04）相关，而女性（sβ=-0.26，p = 0.03）、是患者配偶（sβ=-0.23，p = 0.03）以及有轻度至中度照顾负担（sβ=-0.63，p<0.001）与照顾者中较低的MCS得分相关。
LVAD植入可改善照顾者的心理生活质量。由于照顾者的MCS得分低于普通人群，识别生活质量低风险的家庭照顾者并减轻他们的照顾负担很重要。
