BACKGROUND: Implantation of a ventricular assist device (VAD) reduces short-term mortality and morbidity and provides patients with reasonable quality of life even though it may also be a long-lasting emotional burden. This study was conducted to analyze the long-time emotional consequences of VAD implantation, followed by heart transplantation in patients and spouses. METHODS: This cross-sectional study used the Impact of Event Scale-Revised (IES-R) Version, recording avoidance, intrusion, and hyperarousal, to investigate symptoms of post-traumatic stress disorder (PTSD), and VAD-related fears and concerns. The study cohort comprised 38 patients (36 men, 2 women) and 27 spouses (26 women, 1 man), 6 to 135 months post-operatively. RESULTS: Seven (26%) of the 27 spouses but none of the patients met the criteria for PTSD. Patients who were operated at the early stage of our VAD program (82.0 +/- 31.4 months between implantation and evaluation) were significantly more likely to have a spouse with PTSD syndromes than those whose operation took place later on (42.1 +/- 31.1 months, p = 0.007). Patients with higher avoidance scores and a higher level of hyperarousal were significantly more often affiliated with a PTSD spouse than those with lower avoidance (p = 0.008) and hyperarousal scores (p = 0.001). Spouses displayed significantly higher scores in all IES-R dimensions, and they worried more about device-related problems (malfunctioning, pain, infection, and stroke) than the patients themselves. The noise of the device system was not a crucial issue. CONCLUSION: Our study found that implantation of a VAD, followed by transplantation, does not lead to PTSD in patients but it does in their spouses in the long run. Their emotional well being deserves much closer attention.
BACKGROUND: Implantation of a ventricular assist device (VAD) reduces short-term mortality and morbidity and provides patients with reasonable quality of life even though it may also be a long-lasting emotional burden. This study was conducted to analyze the long-time emotional consequences of VAD implantation, followed by heart transplantation in patients and spouses. METHODS: This cross-sectional study used the Impact of Event Scale-Revised (IES-R) Version, recording avoidance, intrusion, and hyperarousal, to investigate symptoms of post-traumatic stress disorder (PTSD), and VAD-related fears and concerns. The study cohort comprised 38 patients (36 men, 2 women) and 27 spouses (26 women, 1 man), 6 to 135 months post-operatively. RESULTS: Seven (26%) of the 27 spouses but none of the patients met the criteria for PTSD. Patients who were operated at the early stage of our VAD program (82.0 +/- 31.4 months between implantation and evaluation) were significantly more likely to have a spouse with PTSD syndromes than those whose operation took place later on (42.1 +/- 31.1 months, p = 0.007). Patients with higher avoidance scores and a higher level of hyperarousal were significantly more often affiliated with a PTSD spouse than those with lower avoidance (p = 0.008) and hyperarousal scores (p = 0.001). Spouses displayed significantly higher scores in all IES-R dimensions, and they worried more about device-related problems (malfunctioning, pain, infection, and stroke) than the patients themselves. The noise of the device system was not a crucial issue. CONCLUSION: Our study found that implantation of a VAD, followed by transplantation, does not lead to PTSD in patients but it does in their spouses in the long run. Their emotional well being deserves much closer attention.
Authors: Julie T Bidwell; Karen S Lyons; James O Mudd; Jill M Gelow; Christopher V Chien; Shirin O Hiatt; Kathleen L Grady; Christopher S Lee Journal: J Cardiovasc Nurs Date: 2017 Sep/Oct Impact factor: 2.083
Authors: Molly Magid; Jacqueline Jones; Larry A Allen; Colleen K McIlvennan; Katie Magid; Jocelyn S Thompson; Daniel D Matlock Journal: J Cardiovasc Nurs Date: 2016 May-Jun Impact factor: 2.083
Authors: Jennifer S Blumenthal-Barby; Kristin M Kostick; Estevan D Delgado; Robert J Volk; Holland M Kaplan; L A Wilhelms; Sheryl A McCurdy; Jerry D Estep; Matthias Loebe; Courtenay R Bruce Journal: J Heart Lung Transplant Date: 2015-03-31 Impact factor: 10.247
Authors: Colleen K McIlvennan; Jacqueline Jones; Larry A Allen; JoAnn Lindenfeld; Keith M Swetz; Carolyn Nowels; Daniel D Matlock Journal: Circ Cardiovasc Qual Outcomes Date: 2015-03-10