Abstract
ObjectiveTo analyze the psychological evaluations of patients with heart failure waiting for heart transplantation.MethodsThe data were obtained from patient records containing pre-surgery psychological evaluations performed by psychologists from the multidisciplinary cardiology team. The evaluation protocol included the Quality of Life Questionnaire (SF-36), Beck Depression Inventory, and an interview script.ResultsThe results of psychological evaluations performed between 2004 and 2012 for 60 candidates for heart transplantation were analyzed: 43 men and 17 women aged between 16 and 66 years (Mean=45.18; SD=11.91), predominantly from the São José do Rio Preto area (São Paulo state, Brazil) (83%), with incomplete elementary education (68%), and who were in stable relationships (73%). Although women presented higher mean scores for depression (21.41) than men (14.61), there was no significant difference between genders. Women's quality of life was impaired in all domains compared to men (below 50%) and was significantly poorer in the physical functioning (P=0.01), vitality (P=0.00), emotional role functioning (P=0.04), and mental health (P=0.02) domains.ConclusionPatients with psychosocial vulnerability (e.g., depression) identified before transplantation should receive psychological treatment.
Highlights
Heart transplantation aims to improve the life expectancy and quality of life of patients with end-stage heart failure
The sample size corresponds to the number of patients evaluated during this period and is justified by the relatively low frequency of heart transplantations performed at the Institution
According to DATASUS (Department of Informatics of the Unified Health System-SUS), the majority of heart failure hospitalizations occurs in elderly patients, with ages of 60 years or higher, followed by patients in the age range of 20-59 years[13]
Summary
Heart transplantation aims to improve the life expectancy and quality of life of patients with end-stage heart failure. The medical criteria of indication/contraindication for transplantation are well defined, the psychosocial criteria, which affect the results of the procedure, are more difficult to determine[1,2,3,4,5,6,7]. Patients on the heart transplantation waiting list often experience a period of “physical and psychological instability”[1]. The heart transplantation evaluation means the end of a long time living with deteriorating health and the beginning of a new treatment modality. While there is hope for the future, it is necessary to face surgery; despite the risks, the procedure means a chance to survive[1]
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