From the University of Michigan School of Nursing, Ann Arbor, Michigan.
Johns Hopkins University School of Nursing, Baltimore, Maryland.
ASAIO J. 2018 Jul/Aug;64(4):515-520. doi: 10.1097/MAT.0000000000000681.
Psychological distress, including anxiety and depression, is commonly reported by patients with implantable left ventricular assist devices (LVADs). Still, the influence of anxiety and depression on global quality of life (QOL) is unknown. Moreover, the empirical data of LVAD patients' QOL is limited to 24 months. This study examined the differences in anxiety, depression, and QOL based on 3 LVAD implant duration groups (≤12, 13-24, and ≥25 months). We also examined the influence of anxiety and depression on QOL. An observational cross-sectional study design was employed using self-administered demographics, anxiety, depression, and global QOL questionnaires. A total of 100 patients (mean age 52 ± 13.3 years) across the United States completed the study. In the 3 implant duration groups, we found no significant differences in anxiety and depression, but the global QOL scores of patients with LVADs ≥ 13 months were significantly worse than those of patients with LVADs ≤ 12 months. Also, the correlations between QOL and either anxiety or depression were significant: Pearson's r ranged from -0.44 to -0.65 with all p values <0.0001. Compared with anxiety, depression is a stronger predictor of QOL. Our data showed that when depression is increased by 1 unit, the average QOL decreased by 0.76 units, assuming anxiety is held constant. This study uncovered relationships among anxiety, depression, and QOL in patients with long-term LVADs. Longitudinal research is needed to confirm our findings and explore factors that may contribute to worse QOL, particularly, those patients supported with LVADs beyond 13 months.
心理困扰,包括焦虑和抑郁,在植入式左心室辅助装置(LVAD)患者中很常见。然而,焦虑和抑郁对整体生活质量(QOL)的影响尚不清楚。此外,LVAD 患者 QOL 的实证数据仅限于 24 个月。本研究根据 LVAD 植入时间的 3 个组(≤12、13-24 和≥25 个月),研究了焦虑、抑郁和 QOL 的差异。我们还研究了焦虑和抑郁对 QOL 的影响。采用自我管理的人口统计学、焦虑、抑郁和全球 QOL 问卷的观察性横断面研究设计。共有 100 名来自美国的患者完成了研究。在这 3 个植入时间组中,我们没有发现焦虑和抑郁存在显著差异,但 LVAD 植入时间≥13 个月的患者的全球 QOL 评分明显低于 LVAD 植入时间≤12 个月的患者。此外,QOL 与焦虑或抑郁之间存在显著相关性:皮尔逊 r 值范围为-0.44 至-0.65,所有 p 值均<0.0001。与焦虑相比,抑郁是 QOL 的更强预测因素。我们的数据表明,当抑郁增加 1 个单位时,假设焦虑保持不变,平均 QOL 会降低 0.76 个单位。本研究揭示了长期接受 LVAD 治疗的患者中焦虑、抑郁和 QOL 之间的关系。需要进行纵向研究来证实我们的发现,并探讨可能导致 QOL 恶化的因素,特别是那些接受 LVAD 支持超过 13 个月的患者。