The impact of depression and anxiety symptoms on quality of life and social support in therapy with mechanical circulatory support devices: results for patients and their caregivers

Introduction
Mechanical circulatory support (MCS) is a therapy increasingly used in patients with advanced heart failure. Left ventricular assist devices (LVAD) has the potential to improve patient’s quality of life (QoL) significantly and may appreciably impact psychological functioning and social support among patients and their caregivers.

Aim of the research
Assessment of the impact of depression and anxiety symptoms on the QoL and social support in therapy with mechanical circulatory support devices among patients and their caregivers.

Material and methods
The analysis included 54 dyads of patients (median age: 61 years; men 96.30%) and their caregivers (median age: 59 years; men 3.70%). Data were collected 3 months after LVAD implantation. The study used the questionnaires SF-12, Berlin Social Support Scales, and the Hospital Anxiety and Depression Scale, and sociodemographic data.

Results
Caregivers of patients with LVAD assessed the QoL as better than patients (PCS 55.94 vs. 41.87; MCS 48.98 vs. 45.58). Significant differences were found in perceived social-emotional support, need for support, and support seeking. Patients had a higher level of this support. Patients had higher levels of depression and anxiety symptoms than their caregivers. Among patients, depression and anxiety symptoms hurt the mental domain of QoL and the perceived protective buffering of emotional support. Among caregivers, higher intensity of anxiety was associated with a greater need for protective buffering support and a lower need for perceived instrumental support. Predictors of QoL for patients included time since LVAD implantation, depression, and type of device, while among caregivers – age, time since LVAD implantation, and professional activity.

Conclusions
Psychological monitoring and the availability of support during care for the patient and caregiver are recommended.