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Patient Satisfaction Remains High from 3 - 6 Months after Lvad Implant: Findings from Mcs A-qol

Journal of cardiac failure(2020)

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摘要
Objectives Patient satisfaction with having a left ventricular assist device (LVAD) as a bridge to transplantation (BTT) or destination therapy (DT) may change over time early after surgery, as patients adjust to life on a device. We examined satisfaction at 2 time points early after surgery. Methods We evaluated patient self-report data at 3 and 6 months (mos) post implant at 12 U.S. sites (2016-2020). Measures included Satisfaction with Treatment (10 items, [FACIT-TS-G, modified]), VAD Team Communication (6 items, 0 [worst] - 18 [best] communication as wanted, [FACIT-TS-PS, modified]), and Being Bothered by VAD Self-care and Limitations (17 items, 1 [not] - 5 [very much] bothered, [new items]). Bowker's symmetry test was used to compare change in satisfaction for the 10 satisfaction items. Mixed effects models were estimated to assess change in VAD team communication and bother, assuming a missing at random mechanism. Results Patients (n=115) were primarily male (77%) and non-Hispanic White (65%); mean age(SD)=55(12.5) years; 50% had an implant strategy of DT. Overall, no differences were detected regarding satisfaction with having a VAD between 3 and 6 mos after implant. 61% of patients (n=71) were satisfied (for the most part or completely) at 3 mos; of these, 63 (89%) responded similarly at 6 mos. Satisfaction with VAD team communication was high (least-squares means at 3 and 6 mos: 12.3 and 12.8) and being bothered by VAD self-care and limitations was low to moderate (least-squares means at 3 and 6 mos: 2.3 and 2.4), with no change over time (p>0.40). BTT and DT patients reported similar bother (p=0.21), but BTT patient satisfaction with communication was marginally higher than DT patients (p=0.05). Conclusions Patients were quite satisfied with having a VAD early after implant. Patients were also satisfied with communication from the VAD team and reported moderate or fewer hassles with having a VAD, which did not differ by implant strategy. Understanding satisfaction with a VAD may guide patient support early post implant. Patient satisfaction with having a left ventricular assist device (LVAD) as a bridge to transplantation (BTT) or destination therapy (DT) may change over time early after surgery, as patients adjust to life on a device. We examined satisfaction at 2 time points early after surgery. We evaluated patient self-report data at 3 and 6 months (mos) post implant at 12 U.S. sites (2016-2020). Measures included Satisfaction with Treatment (10 items, [FACIT-TS-G, modified]), VAD Team Communication (6 items, 0 [worst] - 18 [best] communication as wanted, [FACIT-TS-PS, modified]), and Being Bothered by VAD Self-care and Limitations (17 items, 1 [not] - 5 [very much] bothered, [new items]). Bowker's symmetry test was used to compare change in satisfaction for the 10 satisfaction items. Mixed effects models were estimated to assess change in VAD team communication and bother, assuming a missing at random mechanism. Patients (n=115) were primarily male (77%) and non-Hispanic White (65%); mean age(SD)=55(12.5) years; 50% had an implant strategy of DT. Overall, no differences were detected regarding satisfaction with having a VAD between 3 and 6 mos after implant. 61% of patients (n=71) were satisfied (for the most part or completely) at 3 mos; of these, 63 (89%) responded similarly at 6 mos. Satisfaction with VAD team communication was high (least-squares means at 3 and 6 mos: 12.3 and 12.8) and being bothered by VAD self-care and limitations was low to moderate (least-squares means at 3 and 6 mos: 2.3 and 2.4), with no change over time (p>0.40). BTT and DT patients reported similar bother (p=0.21), but BTT patient satisfaction with communication was marginally higher than DT patients (p=0.05). Patients were quite satisfied with having a VAD early after implant. Patients were also satisfied with communication from the VAD team and reported moderate or fewer hassles with having a VAD, which did not differ by implant strategy. Understanding satisfaction with a VAD may guide patient support early post implant.
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