Psychological distress in patients with a left ventricular assist device and their partners: An exploratory study

Brouwers, Corline; Denollet, Johan; Çalışkan, Kadir; Jonge, Nicolaas de; Constantinescu, Alina A.; Young, Quincy-Robyn; Kaan, Annemarie; Pedersen, Susanne S.

doi:10.1177/1474515113517607

Cited by 44 publications

(56 citation statements)

References 56 publications

(100 reference statements)

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“…For example, patient depression and anxiety improve post-implantation, 4,9,16 and similarly, we found substantial improvements for patients from pre- to post-VAD. For caregivers, VAD caregiving is characterized by high levels of anxiety from the point of decision onwards, and many caregivers report persistent fear of clinical events and uncertainty for the future (i.e.…”

Section: Discussionsupporting

confidence: 70%

“…4,9 In contrast, there is qualitative evidence that family caregivers of VAD patients are at risk for compromised QOL and high anxiety and depression post-implant. 10-12 Importantly, person-oriented outcomes of patients and their caregivers are typically interdependent – meaning that the outcomes for one member of the family caregiving dyad typically influence the other – both in the context of chronic illness in general, 13 as well as in the context of HF 14,15 and VAD implantation 16 in particular. The inherent interrelatedness of person-oriented outcomes of both members of a patient-caregiver dyad has important implications for research design and interpretation.…”

Section: Introductionmentioning

confidence: 99%

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Quality of Life, Depression, and Anxiety in Ventricular Assist Device Therapy

et al. 2017

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Background: Patients who receive ventricular assist device (VAD) therapy typically rely on informal caregivers (family members or friends) to assist them in managing their device. Objective: The purpose of this study is to characterize changes in person-oriented outcomes (quality of life [QOL], depression, and anxiety) for VAD patients and their caregivers together from pre-implantation to 3 months post-implantation. Methods: This was a formal interim analysis from an ongoing prospective study of VAD patients and caregivers (n = 41 dyads). Data on person-oriented outcomes (QOL: EuroQol 5 Dimensions Visual Analog Scale; depression: Patient Health Questionnaire-8; anxiety: Brief Symptom Inventory) were collected at 3 time points (just prior to implantation and at 1 and 3 months post-implantation). Trajectories of change for patients and caregivers on each measure were estimated using latent growth modeling with parallel processes. Results: Patients’ QOL improved significantly over time, whereas caregiver QOL worsened. Depression and anxiety also improved significantly among patients but did not change among caregivers. There was substantial variability in change on all outcomes for both patients and their caregivers. Conclusions: This is the first quantitative study of VAD patient-caregiver dyads in modern devices that describes change in person-oriented outcomes from pre-implantation to post-implantation. This work supports the need for future studies that account for the inherent relationships between patient and caregiver outcomes and examine variability in patient and caregiver responses to VAD therapy.

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Section: Discussionsupporting

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Quality of Life, Depression, and Anxiety in Ventricular Assist Device Therapy

et al. 2017

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“…In a recent meta-analysis of 38 studies, Easton and colleagues estimated that 32% of patients with heart failure (HF) experience elevated levels of anxiety, and 13% meet criteria for an anxiety disorder [4]. Anxiety also affects approximately 20% of patients with more advanced HF who require implantation of a left ventricular assist device to support their cardiac function [5, 6]. Finally, among patients who have undergone implantation of an implantable cardioverter defibrillator to prevent the development of lethal arrhythmias, elevated anxiety is present in approximately 20-40% [7].…”

Section: Anxiety In Patients With Cardiovascular Diseasementioning

confidence: 99%

Anxiety Disorders and Cardiovascular Disease

Celano

Daunis

Lokko

et al. 2016

Curr Psychiatry Rep

239

160

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Anxiety and its associated disorders are common in patients with cardiovascular disease and may significantly influence cardiac health. Anxiety disorders are associated with the onset and progression of cardiac disease, and in many instances have been linked to adverse cardiovascular outcomes, including mortality. Both physiologic (autonomic dysfunction, inflammation, endothelial dysfunction, changes in platelet aggregation) and health behavior mechanisms may help to explain the relationships between anxiety disorders and cardiovascular disease. Given the associations between anxiety disorders and poor cardiac health, the timely and accurate identification and treatment of these conditions is of the utmost importance. Fortunately, pharmacologic and psychotherapeutic interventions for the management of anxiety disorders are generally safe and effective. Further study is needed to determine whether interventions to treat anxiety disorders ultimately impact both psychiatric and cardiovascular health.

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“…Higher scores on anxiety/ depression over time were associated with poor health status [32] and rehospitalization [33]. Family of patients with LVAD was also increasing anxiety or depression level after implantation [34,35].…”

Section: Brouwers Et Al Reviewed Systematically 16 Quantitative Studmentioning

confidence: 99%

Anxiety and Depression in Cardiovascular Surgery

Okamoto¹,

Motomura²

2017

Depression

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Although anxiety and depression are psychological risk factors for coronary artery disease (CAD), psychological aspect in patients with cardiovascular surgery has been less considered. Cognitive and psychological deficit has been still concerning in spite of notable improvement of cardiovascular surgery using cardiopulmonary bypass perfusion. The purpose of this chapter review is to discuss recent data concerning the prevalence and trend of anxiety and depression of patients with cardiovascular surgery and to introduce the nonpharmacological intervention studies. The prevalence of anxiety and depression of patients after cardiovascular surgeries has varied from 10 to 60% and has been likely higher than that of general people. From the limited studies about patients over 6 months after surgery, we guessed the followings about the trends of anxiety and depression of patients with CABG without any other additional intervention programs before/after surgery: (1) patients improved scores of anxiety and depression 3-6 months after surgery, (2) anxiety decreased considerably for about 6 months after CABG and then leveled out for some time, (3) depression remained a bit higher 6 months and more after CABG. Patients' longitudinal psychological conditions would have been influenced by not only invasive cardiovascular surgery but also life events. The nonpharmacology intervention would have improved patients' psychological conditions. Further research is needed to clarify the long-term psychological outcome and to develop the effective intervention programs toward patients with cardiovascular surgery.

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Psychological distress in patients with a left ventricular assist device and their partners: An exploratory study

Abstract: LVAD partners had significantly higher levels of anxiety than LVAD patients. Emotional distress of LVAD partners should gain more attention, as partners are an essential source of support for LVAD patients.

Cited by 44 publications

References 56 publications

Quality of Life, Depression, and Anxiety in Ventricular Assist Device Therapy

Quality of Life, Depression, and Anxiety in Ventricular Assist Device Therapy

Anxiety Disorders and Cardiovascular Disease

Anxiety and Depression in Cardiovascular Surgery

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