Quality of Life, Depression, and Anxiety in Ventricular Assist Device Therapy: Longitudinal Outcomes for Patients and Family Caregivers.
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.
Julie T. Bidwell, PhD, RN Predoctoral Fellow, Oregon Health & Science University School of Nursing, Portland. Karen S. Lyons, PhD, FGSA Associate Professor, Oregon Health & Science University School of Nursing, Portland. James O. Mudd, MD Associate Professor, Oregon Health & Science University Knight Cardiovascular Institute, Portland. Jill M. Gelow, MD, MPH Assistant Professor, Oregon Health & Science University Knight Cardiovascular Institute, Portland. Christopher V. Chien, MD Assistant Professor, Oregon Health & Science University Knight Cardiovascular Institute, Portland. Shirin O. Hiatt, MPH, MS, RN Research Associate, Oregon Health & Science University School of Nursing, Portland. Kathleen L. Grady, PhD, MS, RN, FAHA, FHSA, FAAN Professor, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. Christopher S. Lee, PhD, RN, FAHA, FHFSA, FAAN Associate Professor, Oregon Health & Science University School of Nursing and Knight Cardiovascular Institute, Portland.
Julie T
JT
Bidwell
Karen S
KS
Lyons
James O
JO
Mudd
Jill M
JM
Gelow
Christopher V
CV
Chien
Shirin O
SO
Hiatt
Kathleen L
KL
Grady
Christopher S
CS
Lee
D000223:Adaptation, Psychological; D001007:Anxiety / Q000517:prevention & control* / Q000523:psychology; D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data*; D003863:Depression / Q000517:prevention & control* / Q000523:psychology; D005195:Family Relations / Q000523:psychology*; D005260:Female; D006333:Heart Failure / Q000628:therapy; D006353:Heart-Assist Devices / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology*