Inoue Tomoko, Sakanaka Naoya, Ota Misato, Noma Takahisa, Yamashita Yoichi, Horii Taiko, Minamino Tetsuo
Department of Cardiorenal and Cerebrovascular Medicine, Faculty of Medicine, Kagawa University Kagawa Japan.
Practical Training of Clinical Psychology, Faculty of Medicine, Kagawa University Kagawa Japan.
Circ Rep. 2025 Feb 21;7(3):147-153. doi: 10.1253/circrep.CR-25-0004. eCollection 2025 Mar 10.
Left ventricular assist devices (LVADs) serve as critical life-sustaining therapy for patients with end-stage heart failure awaiting heart transplantation, significantly improving survival rates and enabling social reintegration. However, many patients with LVAD face multiple challenges in their daily lives and social reintegration, such as anxiety about the device, low societal awareness, and economic and psychological burdens. In Japan, where prolonged waiting periods for heart transplants are inevitable, these challenges further exacerbate the economic and psychological burdens on both patients and caregivers. We present the case of a patient with an LVAD who expressed the desire to return to employment after receiving psychological counseling, and discuss the specific outcomes and challenges of employment support. A multidisciplinary team, including physicians, psychologists, and employment specialists, developed an individualized support plan. This led to successful steps toward social reintegration, which was accomplished in collaboration with the workplace. This case highlights the importance of early intervention during the heart transplant waiting period, specifically the LVAD implantation period, along with continuous psychological, economic, and employment support to improve quality of life post-transplant. Establishing a coordinated support system that involves healthcare providers, employers, and local communities is crucial for the successful social reintegration of patients with an LVAD. Specific measures, such as regular mental health counseling and flexible employment arrangements, are essential to achieving this goal.
左心室辅助装置（LVADs）是终末期心力衰竭患者等待心脏移植时维持生命的关键治疗手段，可显著提高生存率并促进患者重新融入社会。然而，许多LVAD患者在日常生活和重新融入社会方面面临多重挑战，如对装置的焦虑、社会认知度低以及经济和心理负担。在日本，心脏移植等待期较长不可避免，这些挑战进一步加重了患者和护理人员的经济和心理负担。我们介绍了一例LVAD患者在接受心理咨询后表示希望重返工作岗位的案例，并讨论就业支持的具体成果和挑战。一个由医生、心理学家和就业专家组成的多学科团队制定了个性化的支持计划。这促成了朝着成功重新融入社会迈出的步伐，并与工作场所合作得以实现。该案例强调了在心脏移植等待期，特别是LVAD植入期进行早期干预的重要性，以及持续的心理、经济和就业支持对提高移植后生活质量的重要性。建立一个由医疗保健提供者、雇主和当地社区参与的协调支持系统对于LVAD患者成功重新融入社会至关重要。定期进行心理健康咨询和灵活的就业安排等具体措施对于实现这一目标至关重要。
