Gender and Spirituality Influence Patient Care Decisions after LVAD.

Document Type

Conference Proceeding

Publication Date


Publication Title

J Heart Lung Transplant


Purpose: The Quality of Life with an LVAD (QOLVAD) questionnaire is a valid, reliable assessment for QoL in LVAD patients. The final 5 summary items evaluate patient perceptions of overall QoL, adjustment to a VAD and degree of agreement for replacing the VAD if it failed. In our last analysis, we noted that while females rated higher adjustment to living with a VAD, they were less likely to opt for a replacement VAD if it failed and less likely to repeat the entire process again. Our current analysis investigates if these findings can be explained by characteristics of the female cohort. Methods: A prospective, cross-sectional, ongoing 7-site study of adult patients with durable LVADs completing a questionnaire bundle including the QOLVAD and Functional Assessment of Chronic Illness Therapy (FACIT-Sp) surveys. Results: The overall sample included 186 patients (83% male and average age 58 years). Patient responses to the question of opting for a VAD again if they had to repeat the entire process were analyzed (n=178). No statistically significant difference was found based on patients’ marital status (p=0.971), duration of heart failure (p=0.445), education level (p=0.712) and indication for VAD (p=0.702) in patients who responded yes or no. Female patients were analyzed for this same question with respect to indication for VAD with 50% of females responding no being Bridge to Transplant (BTT) (p=0.448). For females responding no to opting for a replacement VAD for VAD failure, 25% were BTT and 50% were Destination Therapy (p=0.338). The FACIT-Sp faith subscale revealed females tended to have more faith than male patients (p=0.0378). Conclusion: The responses of the QOLVAD provide helpful insight into perceptions on VAD adjustment and reimplantation. Our prior study demonstrated differences in responses based on gender. Current findings show higher faith in women compared to men, which has not previously been considered in the differences noted. Other factors like financial or caregiver burden may also contribute to the differences noted. A larger sample of females may have detected statistically significant differences in the select summary questions analyzed based on indication for VAD. This emphasizes the necessity for improved representation of female patients within LVAD studies in order to gain an accurate and insightful understanding on true patient perceptions regarding LVADs.





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