Abstract
Quality of life (QOL)outcomes of left ventricular assist device (LVAD) implantation before and after discharge have only been examined in a very small sample of patients. The purpose of this study was to describe change in QOL outcomes (symptoms, functional ability, stress, and coping) from before to after hospital discharge in 33 VE (vented electric) LVAD patients (94% male, mean age=51 years, 81% white) awaiting heart transplantation. The 33 VE LVAD patients completed the following questionnaires: Heart Failure Symptom Checklist, Sickness Impact Profile, LVAD Stressor Scale, and Jalowiec Coping Scale at 1-2 weeks, 1, 2, 3, 6, 9, and/or 12 months post implant. Average total and subscale scores were determined for each instrument, and data were analyzed using one sample t-tests. A more stringent level of significance was set (0.01) due to the use of multiple comparisons. Functional disability decreased from before to after discharge (physical disability: rate of change=0.07 units/month, t=-2.95, p=0.006; and self-care disability: rate of change=0.14 units/month, t=-3.83, p=0.001). Stress also decreased from before to after discharge: total stress (rate of change=0.09 units/month, t=-3.617, p=0.001), self-care stress (0.09 units/month, t=-2.73, p=0.01), family-related stress (rate of change=0.17 units/month, t=-3.45, p=0.002), work-related stress (rate of change=0.14 units/month, t=-2.92, p=0.006), and psychological stress (rate of change=0.10, t=-4.00, p<0.001). Effectiveness of optimistic coping strategies decreased from before to after discharge (rate of change=0.10 units/month, t=-2.99, p=0.006). No change in symptom distress was found from before to after discharge. In conclusion, physical and psychosocial domains of QOL improved when patients were discharged from the hospital. Long-term QOL research in LVAD patients is important especially as LVADs become destination therapy.
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