Richter Fabian, Kugler Christiane, Tigges-Limmer Katharina, Albert Wolfgang
Institute of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité - Medical Heart Center of Charité and German Heart Institute Berlin, Berlin, Germany.
Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Artif Organs. 2025 Jan;49(1):129-136. doi: 10.1111/aor.14856. Epub 2024 Sep 6.
Little is known about the disturbance in bodily experience (BE) following ventricular assist device (VAD) implantation. The level of disturbance in BE serves as an indicator of the status of the patients' adaptation process to the device. This process encompasses coping with both the more affective, psychological conflicts and the more cognitive, practical challenges of living with the VAD. To provide an economical screening tool for everyday clinical practice, we refined and validated a questionnaire on BE in VAD patients.
Seven specific items were derived from clinical experience and presented to 365 VAD patients (85% male; time since implantation: 3-36 months). The item structure was examined using factor analyses and probabilistic test theory. Discriminant validity and change sensitivity were determined in relation to associated psychometric instruments.
Four items were found to constitute the unidimensional bodily experience scale (BE-S). Besides a high internal consistency of the scale (ω = 0.86), the RMSEA of >0.01 indicates a very good model fit. The BE-S has high convergent validity with related constructs (Hospital Anxiety and Depression Scale, Kansas City Cardiomyopathy Questionnaire). Change sensitivity analyses proved the BE-S alone to be significantly sensitive to the temporal dynamics of psychological adaptation processes following VAD implantation.
The BE-S constitutes a valid and economical tool for clinical practice to assess patients' disturbance in BE after VAD implantation. It is a valuable tool for identifying patients with difficulties in adapting to the VAD. Subsequently, it enables early and focused therapeutic support for these patients at risk.
关于心室辅助装置（VAD）植入后身体体验（BE）的紊乱情况，人们了解甚少。BE的紊乱程度可作为患者对该装置适应过程状态的一个指标。这个过程包括应对情感上、心理上的冲突以及VAD使用者在认知上、实际生活中的挑战。为了提供一种适用于日常临床实践的经济筛查工具，我们对一份关于VAD患者BE的问卷进行了完善和验证。
从临床经验中提炼出七个具体项目，并将其呈现给365名VAD患者（85%为男性；植入后时间：3 - 36个月）。使用因子分析和概率测试理论对项目结构进行检验。根据相关心理测量工具确定判别效度和变化敏感性。
发现四个项目构成了单维身体体验量表（BE - S）。该量表不仅具有较高的内部一致性（ω = 0.86），且均方根误差近似值（RMSEA）>0.01表明模型拟合度非常好。BE - S与相关结构（医院焦虑抑郁量表、堪萨斯城心肌病问卷）具有较高的收敛效度。变化敏感性分析证明，仅BE - S对VAD植入后心理适应过程的时间动态变化就非常敏感。
BE - S是一种用于临床实践的有效且经济的工具，可评估VAD植入后患者的身体体验紊乱情况。它是识别难以适应VAD的患者的有价值工具。随后，它能够为这些有风险的患者提供早期且有针对性的治疗支持。
