Coping, Mood, Quality of Life, and Outcomes in Recipients of Left Ventricular Assist Devices: A Cluster Analysis
| Autor: | Anna Minotti, Maurizio Ferratini, Anna Scaglione, Manlio Cipriani, Bruno Bordoni, Claudio Russo, Maddalena Modica, Renata De Maria, Vittorio Racca |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Heart Ventricles Anxiety Hospital Anxiety and Depression Scale 03 medical and health sciences 0302 clinical medicine Internal medicine Adaptation Psychological medicine Cluster Analysis Humans Applied Psychology Heart Failure Depression business.industry Hazard ratio Middle Aged medicine.disease Confidence interval 030227 psychiatry Psychiatry and Mental health Treatment Outcome Mood Mood disorders Heart failure Quality of Life Female Heart-Assist Devices medicine.symptom business 030217 neurology & neurosurgery Destination therapy |
| Zdroj: | Psychosomatic Medicine. 81:192-199 |
| ISSN: | 1534-7796 0033-3174 |
| DOI: | 10.1097/psy.0000000000000658 |
| Popis: | OBJECTIVE Left ventricular assist devices (LVADs) are increasingly used for temporary circulatory support until transplant or as destination therapy for patients with end-stage heart failure. Understanding patients' attitudes and resources is crucial to support them. METHODS Sixty-one LVAD recipients (55 [10] years, 10% women, 15% destination therapy) participating in cardiac rehabilitation (CR) postimplant underwent assessment of coping styles (Coping Orientation for Problem Experiences), quality of life (Medical Outcomes Study Short-Form 36, Minnesota Living with Heart Failure Questionnaire), and mood (Hospital Anxiety and Depression Scale). RESULTS Cluster analysis identified two homogeneous groups: C1 (n = 18) patients had higher anxiety (9.6 [5.0] versus 4.0 [2.7], p < .001), depression (10 [3.0] versus 4 [2.7], p < .001), and avoidant coping (29 [5.2] versus 21.2 [3.8], p < .001) scores and worse quality of life (Short-Form 36 of the Medical Outcomes Study Physical Component Scale 31 [5.3] versus 35.6 [6.9], p < .001; Mental Component Scale 34.3 [6.8] versus 50.3 [8], p < .001; MLHFQ physical 26 [7.2] versus 13.9 [8.2], p < .001; emotional 17.7 [3.4] versus 3.86 [3.2], p < .001) than C2 participants (n = 43). During 31 (15-54) months, 20 patients (33%) died. By Cox multivariable analysis, after adjustment for age, sex, Interagency Registry for Mechanically Assisted Circulatory Support level at surgery, and meters walked during 6 minutes at CR discharge, C1 was associated with mortality (hazard ratio = 2.858; 95% confidence interval = 1.102-7.408, p = .031; model χ = 7.286, df = 5, p = .20). Survival was 44% in C1 and 77% in C2 (log-rank p = .033). CONCLUSIONS Among patients discharged from CR after LVAD implant, one third show a profile characterized by worse perceived quality of life, mood disorders, and dysfunctional coping that is associated with long-term mortality, and these factors are potential targets for post-LVAD intensive support. |
| Databáze: | OpenAIRE |
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