新型心室辅助装置自我报告测量与总体健康相关生活质量的关联
Association of Novel Ventricular Assist Device Self-report Measures With Overall Health-Related Quality of Life.
作者信息
Grady Kathleen L, Burns James L, Allen Larry A, Stehlik Josef, Teuteberg Jeffrey, McIlvennan Colleen K, Kirklin James K, Beiser David G, Lindenfeld JoAnn, Denfeld Quin E, Lee Christopher S, Kiernan Michael, Cella David, Klein Liviu, Walsh Mary Norine, Ruo Bernice, Adler Eric, Rich Jonathan, Pham Duc Thinh, Yancy Clyde, Murks Catherine, Bedjeti Katy, Hahn Elizabeth A
出版信息
J Cardiovasc Nurs. 2024 Sep 11. doi: 10.1097/JCN.0000000000001129.
BACKGROUND
Few study authors examined factors influencing health-related quality of life (HRQOL) early after left ventricular assist device (LVAD) implantation.
OBJECTIVE
The purpose of this study was to determine whether 5 novel self-report measures and other variables were significantly associated with overall HRQOL at 3 months after LVAD surgery.
METHODS
Patients were recruited between October 26, 2016, and February 29, 2020, from 12 US sites. Data were collected before LVAD implantation and at 3 months post LVAD implantation. Overall HRQOL measures included the Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12) overall summary score (OSS) and EuroQol 5-dimension- 3L visual analog scale. Potential factors associated with overall HRQOL included 5 novel self-report measures (Satisfaction with Treatment, Being Bothered by VAD Self-care and Limitations, VAD Team Communication, Self-efficacy regarding VAD Self-care, and Stigma), and demographic and clinical characteristics. Statistics included regression analyses.
RESULTS
Of enrollees, 242 completed self-report measures at baseline, and 142 completed measures 3 months postoperatively. Patients were 55 ± 13 years old, with 21% female, 24% non-White, 39% high school or lower educated, and 47% destination therapy. Using the KCCQ-12 OSS, higher Satisfaction with Treatment was associated with a higher KCCQ-12 OSS; Being Bothered by VAD Self-care and Limitations, high school or lower education, chest incision pain, cardiac dysrhythmias within 3 postoperative months, and peripheral edema were associated with a worse KCCQ-12 OSS (R2 = 0.524). Factors associated with a worse 3-month EuroQol 5-dimension-3L visual analog scale were female sex, adverse events within 3 months post implantation (cardiac dysrhythmias, bleeding, and venous thrombosis), and chest incision pain (R2 = 0.229). No factors were associated with a higher EuroQol 5-dimension-3L visual analog scale score at 3 months.
CONCLUSIONS
Two novel measures, demographics, postimplantation adverse events, and symptoms were associated with post-LVAD KCCQ-12 OSS early after surgery.
背景
很少有研究作者探讨左心室辅助装置（LVAD）植入术后早期影响健康相关生活质量（HRQOL）的因素。
目的
本研究的目的是确定5种新的自我报告测量方法和其他变量是否与LVAD手术后3个月的总体HRQOL显著相关。
方法
2016年10月26日至2020年2月29日期间，从美国12个地点招募患者。在LVAD植入前和LVAD植入后3个月收集数据。总体HRQOL测量包括堪萨斯城心肌病问卷-12（KCCQ-12）总体总结评分（OSS）和欧洲五维健康量表3L视觉模拟量表。与总体HRQOL相关的潜在因素包括5种新的自我报告测量方法（对治疗的满意度、因VAD自我护理和限制而烦恼、VAD团队沟通、VAD自我护理的自我效能感和耻辱感）以及人口统计学和临床特征。统计分析包括回归分析。
结果
在入组者中，242人在基线时完成了自我报告测量，142人在术后3个月完成了测量。患者年龄为55±13岁，女性占21%，非白人占24%，高中及以下学历占39%，目标治疗占47%。使用KCCQ-12 OSS，对治疗的满意度越高，KCCQ-12 OSS越高；因VAD自我护理和限制而烦恼、高中及以下学历、胸部切口疼痛、术后3个月内的心律失常和外周水肿与较差的KCCQ-12 OSS相关（R2 = 0.524）。与术后3个月欧洲五维健康量表3L视觉模拟量表较差相关的因素包括女性、植入后3个月内的不良事件（心律失常、出血和静脉血栓形成）和胸部切口疼痛（R2 = 0.229）。没有因素与术后3个月欧洲五维健康量表3L视觉模拟量表评分较高相关。
结论
两种新的测量方法、人口统计学、植入后不良事件和症状与LVAD术后早期的KCCQ-12 OSS相关。
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