Relationship of Spiritual Wellbeing and Depressive Symptoms for Patients with a Left-Ventricular Assist Device (LVAD).
Sandau KE, Lee CS, Garberich R, Weaver CE, Joseph S, Hall SA, Carey S, Cowger JA, Chaudhry SP, Schroeder SE, Hoffman RO, Feldman D, Conway G, Birati EY, Soni M, Marble J, Kunz MS, Storey KM, Faulkner KM, and Eckman P. Relationship of Spiritual Wellbeing and Depressive Symptoms for Patients with a Left-Ventricular Assist Device (LVAD). J Heart Lung Transplant 2019; 38(4 Suppl):S302.
J Heart Lung Transplant
Purpose: Although quality of life (QOL) has been widely reported in patients receiving LVADs, spiritual wellbeing among LVAD recipients is rarely included in these reports. Methods: Prospective, multi-site, cross-sectional, descriptive study of patient-reported outcomes. Depressive symptoms were measured by PHQ9 (lower = fewer symptoms). Spiritual wellbeing was measured through two different questionnaires. The Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being scale (FACIT-Sp) (12-items) is an established independent measure (possible score 0-48, higher better) with a faith subscale (score 0-16) and a meaning/peace subscale (score 0-32). The QOLVAD Meaning/Spirituality subscale (5-items) is one of five domains for QOL included in the new, valid and reliable Quality of Life with an LVAD (QOLVAD) questionnaire (domain possible score 0-100, higher better). Results: There were 186 LVAD patients in the overall sample: 83% male, 77% white, 22% African American, 90% HeartMate II and 3, 50% bridge to transplant, 30% destination therapy, with average age of 58.5±13.8 years. We report preliminary findings from surveys completed at median time (25th, 75th percentile) of 44 weeks (17.5±115.5) post-VAD. Faith affiliation was 69% Protestant, 19% Catholic, 6% Agnostic/Atheist, and 6% other. The mean PHQ9 score was 3.97±4.16 and FACIT-Sp 38.7±8.8. Meaning/Peace and Faith subscale scores were 26.1±5.5 and 13.0±4.0, respectively. The PHQ9 and the faith subscale of the FACIT-Sp had a significant inverse relationship (r = -0.2166, p=0.004), suggesting that patients with higher faith had fewer depressive symptoms. Similarly, scores for the PHQ and the Meaning/Spirituality subscale of the QOLVAD had a significant inverse relationship (r = -0.3121; p<0.001), suggesting that patients with higher wellbeing in meaning and spirituality had fewer depressive symptoms. Conclusion: Spiritual wellbeing is an important facet of assessing patient-reported outcomes in LVAD patients. Given the strong inverse correlation between spiritual wellbeing and depressive symptoms, some patients may benefit from interventions targeted at improving spiritual wellbeing during LVAD support. Findings may suggest a role for institutional support of resources to promote patient spiritual wellbeing.