Faculty of Medicine, Institute of Nursing Science, University of Freiburg, Breisacher Str. 153, Freiburg 79110, Germany.
Team Psychosomatics, German Heart Center Berlin, Germany.
Heart Lung. 2024 Jan-Feb;63:92-97. doi: 10.1016/j.hrtlng.2023.10.003. Epub 2023 Oct 12.
Advanced heart failure therapies such as durable ventricular assist device (VAD) support require psychosocial adjustment for those affected. Since VAD implantation has become an established treatment strategy, a focus on psychosocial factors is needed.
To investigate the construct of psychosocial adjustment and to further understand the role of social support.
In a nation-wide, multi-center, cross-sectional study, we recruited 393 participants with ongoing VAD support (3mts-3yrs on device; clinicaltrials.gov ID: NCT04234230). Patient demographics, psychosocial adjustment (perceived social support, anxiety, depression, and quality of life), and major adverse events (thromboembolic events, bleeding, driveline infections) were assessed.
Overall, 85.8 % of the sample were male; mean age was 58.3 years (range 18-85). The majority of the sample (89.3 %) reported normal to high perceived social support. Participants expressed symptoms of anxiety within the normal range (M=6.0±3.9), mildly elevated depressive symptoms (HADS: M=7.6±2.9; PHQ-9: M=6.2±4.7), and good quality of life (KCCQ: M=65.3±17.9). Higher perceived social support was associated with lower levels of anxiety and depression, and higher levels of quality of life within our sample (all p<0.001). Driveline infection was the most prevalent adverse event (0.304 infections per person-years [32.6 % of patients]). Binary logistic regression models did not identify significant associations for the occurrence of adverse events and variables of psychosocial adjustment.
Our sample perceived high levels of psychosocial adjustment. High perceived social support was associated with better outcomes in levels of anxiety, depression, and quality of life, demonstrating potential for the future development and evaluation of targeted multi-professional social support interventions including peer- and caregiver support.
耐用型心室辅助装置（VAD）等先进的心力衰竭治疗方法需要受影响者进行心理社会调整。由于 VAD 植入已成为一种既定的治疗策略，因此需要关注心理社会因素。
研究心理社会调整的结构，并进一步了解社会支持的作用。
在一项全国性、多中心、横断面研究中，我们招募了 393 名正在接受 VAD 支持的患者（装置使用 3 个月至 3 年；临床试验.gov ID：NCT04234230）。评估了患者的人口统计学特征、心理社会调整（感知社会支持、焦虑、抑郁和生活质量）和主要不良事件（血栓栓塞事件、出血、导线感染）。
总体而言，样本中 85.8%为男性；平均年龄为 58.3 岁（范围 18-85）。大多数样本（89.3%）报告感知社会支持正常或较高。参与者表现出正常范围内的焦虑症状（M=6.0±3.9）、轻度升高的抑郁症状（HADS：M=7.6±2.9；PHQ-9：M=6.2±4.7）和良好的生活质量（KCCQ：M=65.3±17.9）。在我们的样本中，较高的感知社会支持与较低的焦虑和抑郁水平以及较高的生活质量水平相关（均 p<0.001）。导线感染是最常见的不良事件（0.304 人年感染[32.6%的患者]）。二元逻辑回归模型未发现不良事件发生与心理社会调整变量之间存在显著关联。
我们的样本感知到高水平的心理社会调整。较高的感知社会支持与焦虑、抑郁和生活质量水平的改善相关，这表明未来可能需要开发和评估针对多专业社会支持干预措施，包括同伴和照顾者支持。
