Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany.
Department of Cardiology, University of Heidelberg, Heidelberg, Germany.
Artif Organs. 2024 Dec;48(12):1484-1493. doi: 10.1111/aor.14825. Epub 2024 Jul 10.
Due to its high impact on quality of life and mental health, close monitoring and often psychotherapy is recommended for patients with a ventricular assist device (VAD). This study investigates the psychological comorbidity and the corresponding psychotherapeutic treatment situation of VAD patients. Special attention is also given to the professional perspective VAD team (assistant and senior cardiologists and specialized nurses).
We conducted a cross-sectional observational study. Data from 50 VAD patients (mean age = 53.52, standard deviation = 13.82 years, 84.0% male) and their VAD team were analyzed. The presence of a psychological disorder was evaluated by structured clinical interviews for DSM-IV (SCID-I-Interviews). Patients answered a questionnaire regarding their current psychotherapeutic treatment status and their attitude towards psychotherapy. The VAD team answered a questionnaire about the patients' needs for psychotherapy and indicated whether they addressed this topic with the patient. Data were analyzed descriptively, by analysis of variance and t-test.
A total of 58% of VAD patients suffered from at least one significant psychological disorder, 79.3% of those were not in psychotherapy. The VAD team could not identify the patients who suffered from a psychological disorder (F = 1.90; p = 0.18). They perceived more need for psychotherapy than they addressed with their patients (T = 3.39; p < 0.001).
While there is a high psychological morbidity among VAD patients, only few receive psychotherapy. Psychological comorbidity is not easily detected by the VAD team. Standardized psychosocial care could be implemented by regular psychological assessments and further information of patients and their VAD teams.
由于心室辅助装置（VAD）对生活质量和心理健康有重大影响，建议对患者进行密切监测和经常进行心理治疗。本研究调查了 VAD 患者的心理共病情况和相应的心理治疗情况。特别关注 VAD 团队（助理和高级心脏病专家和专门护士）的专业观点。
我们进行了一项横断面观察性研究。分析了 50 名 VAD 患者（平均年龄 53.52 岁，标准差 13.82 岁，84.0%为男性）及其 VAD 团队的数据。通过 DSM-IV 结构临床访谈（SCID-I-Interviews）评估是否存在心理障碍。患者回答了一份关于当前心理治疗状况及其对心理治疗态度的问卷。VAD 团队回答了一份关于患者对心理治疗需求的问卷，并指出他们是否与患者讨论了这个话题。数据采用描述性分析、方差分析和 t 检验进行分析。
共有 58%的 VAD 患者患有至少一种显著的心理障碍，其中 79.3%的患者未接受心理治疗。VAD 团队无法识别患有心理障碍的患者（F=1.90；p=0.18）。他们认为自己的患者需要更多的心理治疗，但与患者讨论的却较少（T=3.39；p<0.001）。
尽管 VAD 患者存在较高的心理发病率，但只有少数患者接受心理治疗。VAD 团队不易发现心理共病。通过定期进行心理评估以及为患者及其 VAD 团队提供更多信息，可以实施标准化的心理社会护理。
