Psychosocial and economic problems and quality of life in patients with left ventricular assist device implantation and heart transplantation

Left ventricular assist device (LVAD) implantation and heart transplantation are important factors that lead patients to experience psychosocial, economic problems and alterations in quality of life. The aim of this study is to determine the psychosocial and economic problems and quality of life of patients with implanted left ventricular assist device and who had undergone cardiac transplantation. This descriptive study was conducted between 02.01.2018-01.05.2018 in Baskent University Ankara Hospital with inpatients of Cardiovascular Surgery Adult Ward and Outpatients of Cardiology Clinic via face to face interview. Twenty one patients with Left ventricular assist device implantation and 45 patients undergoing cardiac transplantation who were willing to participate in the research were included in the study. The data of the study were collected by descriptive characteristics of patients and problem determination form for Left ventricular assist device and heart transplantation and SF-36 quality of life scale. Of the patients with Left ventricular assist device implantation 57,1 % were in the age group of 54-74 years; 90,5 % were male; 81,0% were single; 4,6% were primary school graduates; 61,9 % were unemployed and 38,1 % had balanced income and expenditures. A majority of patients in the research reported that they were experiencing economic and psychosocial problems such as social isolation and withdraw. A statistically significant difference was found between physical functioning, role limitations due to emotional problems, pain and general health subscale scores of SF-36 QOL scale and employment status of patients with Left ventricular assist device implantation and cardiac transplantation. The mean physical functioning, role limitations due to emotional problems, pain and general health scores employed patients were found to be higher compared to unemployed patients. There was a statistically significant difference between the two groups in terms of survival time after surgery (p <0.05). The survival rate for patients who underwent Left ventricular assist device implantation and cardiac transplantation 5 years after surgery was 10,0% and 47,0% respectively. The main reason for hospital addmittion was complications for 62,0 % of the patients with Left ventricular assist device implantation, and 69,0% of the patients who underwent cardiac transplantation admitted to hospital for follow-up. The physical functioning scores of the patients admitted to hospital due to complication were found to be 10,53 points lower than patients presenting due to follow-up. Patients who underwent heart transplantation were found to have 13,10 points higher physical functioning score compared to the patients who underwent Left ventricular assist device implantation. It was found that there was a significant difference between patients' general health subscale score of SF-36 quality of life scale and the reason to admit hospital within one year (p<0.05). General health" subscale scores of the patients admitted to hospital due to complication were found to be 15,24 points lower than patients admit to hospital due to follow-up. Role limitations due to physical health" subscale scores of admit the patients to hospital due to complication were found to be 24 points lower than patients due to follow-up. Patients experience psychosocial and economic problems during post-surgical processes. Left ventricular assist device implantation or heart transplantation adversely affects the quality of life of patients. Employed patients have positive results in regard to subscales of quality of life. Complications are affecting patients' quality of life negatively. Training materials and brochures should be developed that can facilitate the daily lives of patients, improve treatment compliance, and provide information on symptoms and signs of complications they may encounter.