High level of psychosocial adjustment in patients on ongoing ventricular assist device support in the years one to three after VAD implantation-A national multi-center Study

Background: Advanced heart failure therapies such as durable ventricular assist device (VAD) support require psychosocial adjustment for those affected. Since VAD implantation has become an established treatment strategy, a focus on psychosocial factors is needed. Objectives: To investigate the construct of psychosocial adjustment and to further understand the role of social support. Methods: In a nation-wide, multi-center, cross-sectional study, we recruited 393 participants with ongoing VAD support (3mts-3yrs on device; clinicaltrials.gov ID: NCT04234230). Patient demographics, psychosocial adjustment (perceived social support, anxiety, depression, and quality of life), and major adverse events (thromboembolic events, bleeding, driveline infections) were assessed. Results: Overall, 85.8 % of the sample were male; mean age was 58.3 years (range 18-85). The majority of the sample (89.3 %) reported normal to high perceived social support. Participants expressed symptoms of anxiety within the normal range (M=6.0 +/- 3.9), mildly elevated depressive symptoms (HADS: M=7.6 +/- 2.9; PHQ-9: M=6.2 +/- 4.7), and good quality of life (KCCQ: M=65.3 +/- 17.9). Higher perceived social support was associated with lower levels of anxiety and depression, and higher levels of quality of life within our sample (all p<0.001). Driveline infection was the most prevalent adverse event (0.304 infections per person-years [32.6 % of patients]). Binary logistic regression models did not identify significant associations for the occurrence of adverse events and variables of psychosocial adjustment. Conclusion: Our sample perceived high levels of psychosocial adjustment. High perceived social support was associated with better outcomes in levels of anxiety, depression, and quality of life, demonstrating potential for the future development and evaluation of targeted multi-professional social support interventions including peerand caregiver support.

Automated summary

This study investigated the construct of psychosocial adjustment and the role of social support in patients with durable VAD support. The results showed that the majority of the participants reported high levels of perceived social support and good psychosocial adjustment. Higher levels of perceived social support were associated with lower levels of anxiety and depression, and higher levels of quality of life.