Dahrmann Birte, Sindermann Jürgen, Geldmacher Thomas, Heuft Gereon
Klinik für Psychosomatik und Psychotherapie Universitätsklinikum Münster Domagkstr. 22 D-48149 Münster Deutschland Klinik für Psychosomatik und Psychotherapie - UKM Münster.
Klinik für Herzchirurgie Universitätsklinikum Münster Deutschland Klinik für Herzchirurgie - Universitätsklinikum Münster.
Z Psychosom Med Psychother. 2017 Dec;63(4):388-404. doi: 10.13109/zptm.2017.63.4.388.
Quality of life and mental health of patients with severe heart failure with or without technical support for the left cardiac ventricle - a cross-sectional study Objectives: Chronic heart failure is associated with reduced quality of life (QoL) and poor prognosis. Support via a left ventricular assist device (LVAD) is an alternative to optimised medical management for patients with advanced heart failure. This study evaluated health-related QoL with both therapy options.
In this consecutive cross-sectional study, patients with LVAD support (n = 50) and patients with optimised medical management (n = 50) were interviewed comprehensively about various domains of QoL, emotional stress, perceived self-efficacy, social support, life satisfaction, and communication.
LVAD patients had a better overall QoL (KCCQ, clinical summary: MW: 67.4 vs. 52.9). Patients with medical management reported increased emotional stress stemming from depressed mood (HADS-D, MW: 7.1 vs.MW: 6.0). Depressed mood proved to be the most significant negative predictor for health-related QoL as well as for emotional well-being.
Although they had a worse clinical situation preoperatively, LVAD patients had a significantly better QoL in both physical dimensions and functional competencies as well as significantly less psychological stress through depressed mood and anxiety.
有或无左心室技术支持的严重心力衰竭患者的生活质量和心理健康——一项横断面研究 目的:慢性心力衰竭与生活质量(QoL)降低和预后不良相关。对于晚期心力衰竭患者,通过左心室辅助装置(LVAD)提供支持是优化药物治疗的一种替代方案。本研究评估了这两种治疗方案下与健康相关的生活质量。
在这项连续横断面研究中,对接受LVAD支持的患者(n = 50)和接受优化药物治疗的患者(n = 50)就生活质量的各个领域、情绪压力、自我效能感、社会支持、生活满意度和沟通情况进行了全面访谈。
LVAD患者的总体生活质量更好(堪萨斯城心肌病问卷,临床总结:中位数得分:67.4对52.9)。接受药物治疗的患者报告称,因情绪低落导致的情绪压力增加(医院焦虑抑郁量表 - 抑郁分量表,中位数得分:7.1对6.0)。事实证明,情绪低落是与健康相关的生活质量以及情绪幸福感最显著的负面预测因素。
尽管LVAD患者术前临床情况较差,但在身体维度和功能能力方面,他们的生活质量明显更好,并且因情绪低落和焦虑导致的心理压力明显更小。