Psychological difficulties of LVAD patients and caregivers: A follow up over one year from discharge.

BACKGROUND: After the rehabilitation program, patients with left ventricular assist device (LVAD) are discharged home, but the adaption to the daily life with the implant is challenging, both with practical and psychological consequences. Literature is lacking detailed information about the quality of life of LVAD patients and caregivers after discharge to home. OBJECTIVE: This study aimed at evaluating the post-discharge outcomes of both LVAD patients and their caregivers in terms of quality of life, affectivity, and psychological health. METHODS: In this observational follow-up study, LVAD dyads discharged home from 1 year to 6 years were re-contacted by phone and received by mail an envelope with self-report questionnaires. Responses of 39 complete dyads of patients (mean age 68.59 ± 4.31; males: 92.31%) and their caregivers (mean age 61.59 ± 11.64; males: 17.95%) were analyzed. RESULTS: Patients and caregivers reported the moderate levels of anxiety, depression, and caregiver strain, and Illness denial and conscious avoidance were associated between them. The couples often reported that the LVAD has impairments for their sleep and for their affective-sexual relationship. Caregivers often reported impairment in social life and self-care. DISCUSSIONS: Despite the satisfaction for the medical and territorial assistance, patients showed psychological difficulties such as anxious and depressive symptoms and caregivers tend to neglect themselves. Even after a long time from discharge to home, the psychological distress of LVAD patients and caregivers is still considerable. Structured and continuous psychological interventions are required to support their psychological health overtime after the discharge to home.