Albert Wolfgang, Spielmann Hannah, Semmig-Koenze Sandra, Knosalla Christoph, Mulzer Johanna, Tigges-Limmer Katharina, Kugler Christiane, Richter Fabian
Deutsches Herzzentrum der Charité, Department of Cardiothoracic and Vascular Surgery, Berlin, Germany.
Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.
Artif Organs. 2025 Jul;49(7):1099-1107. doi: 10.1111/aor.14996. Epub 2025 Mar 17.
Disturbance in bodily experience (BE) after ventricular assist device (VAD) implantation is common. This study aims to investigate the effect of focused psychological support to improve BE in VAD patients.
This national, multicenter, longitudinal study enrolled 140 VAD patients from four centers across Germany in a prospective, randomized controlled trial. Patients were randomized (1:1) to receive curricular and focused psychological intervention in the post-implantation step-down units after implantation (n = 70) or treatment as usual (n = 70). BE was assessed using the Bodily Experience Scale in VAD Patients (BE-S) after implantation (baseline) and followed up 12 months later. Data were analyzed using mixed-effects models.
VAD patients with disturbance in BE (BE-S ≥ 2) after implantation (n = 43, 63.24%) benefit from the targeted intervention. Compared to the subsample of the control group (CG) patients with initial BE disturbance (n = 46, 69.7%), the intervention group (IG) displays a significantly stronger decrease from baseline to the 1-year follow-up (p = 0.01). Generally, women (p = 0.4) and emergently implanted patients (p = 0.24) show a smaller, albeit not significant, decrease in BE disturbance. All patients have high overall gratitude scores, which increase slightly but not significantly over time.
The efficacy of targeted psychological support in reducing disturbance in BE among VAD patients is highlighted. Given the strong correlation between BE and other mental health domains, such as anxiety and depression, it is essential to address disturbances in BE to improve the overall mental health of VAD patients.
心室辅助装置（VAD）植入后身体体验紊乱（BE）很常见。本研究旨在探讨针对性心理支持对改善VAD患者BE的效果。
这项全国性、多中心、纵向研究在一项前瞻性随机对照试验中纳入了来自德国四个中心的140名VAD患者。患者被随机分为两组（1:1），一组在植入后在植入后逐步下调病房接受课程和针对性心理干预（n = 70），另一组接受常规治疗（n = 70）。植入后（基线）使用VAD患者身体体验量表（BE-S）评估BE，并在12个月后进行随访。使用混合效应模型分析数据。
植入后有BE紊乱（BE-S≥2）的VAD患者（n = 43，63.24%）从针对性干预中获益。与对照组（CG）初始有BE紊乱的子样本患者（n = 46，69.7%）相比，干预组（IG）从基线到1年随访的下降幅度明显更大（p = 0.01）。总体而言，女性（p = 0.4）和紧急植入患者（p = 0.24）的BE紊乱下降幅度较小，尽管不显著。所有患者的总体感恩得分都很高，且随时间略有增加但不显著。
强调了针对性心理支持在减少VAD患者BE紊乱方面的有效性。鉴于BE与焦虑和抑郁等其他心理健康领域之间存在强相关性，解决BE紊乱对于改善VAD患者的整体心理健康至关重要。
