ABSTRACT
BACKGROUND: Cardiovascular diseases represent one of the most important problems for public health. Research indicates that elderly patients consider sexual satisfaction as a fundamental aspect of their quality of life and a better sexual function is related to higher general wellbeing. OBJECTIVE: The main objective of this study was to investigate the mediating role of anxiety and depression in the relationship between quality of life and sexual satisfaction in cardiovascular (CVD) patients. METHODS: The sample comprised 128 adult patients, males and females, hospitalized in a Cardiology Rehabilitation clinical center. To collect data, the following were used: a demographic information sheet, the left ventricular ejection fraction (EF) to evaluate cardiac function, cardiovascular diagnosis type, the HADS scale to evaluate anxiety and depression states, a test for sexual satisfaction evaluation (SAS) and the SF-36 survey to measure quality of life. RESULTS: The results indicated that only SF-36 physical health is indirectly related to SAS through its relationship with anxiety. CONCLUSION: A mediating model was proposed to explore the underlying association between sexual satisfaction and quality of life. We recommend investigating perceived general health and sexuality as clinical indicators for therapeutic decisions and risk evaluation for the management of cardiovascular diseases.
ABSTRACT
BACKGROUND: Left ventricular assist devices (LVAD) are the most common mechanical circulatory support for patients with advanced heart failure, and can be used either as a temporary or permanent therapy. Normally, LVAD carriers show psychological distress related to the difficulties in adapting to their new clinical condition. METHODS: This retrospective study aimed to analyze the quality of life of 21 patients after LVAD implantation and follow-up in a dedicated psychology outpatient clinic. The Short Form Health Survey (SF-36) was used to assess the quality of life, and the Hospital Anxiety and Depression Scale (HADS) to measure anxiety and depression levels. These constructs were examined according to the time of implant and their age, with correlational analyses. RESULTS: Outcomes seem to affect the quality of life of our population when compared with regulatory data, in terms of both physical health and mental health. Patient age was inversely related to the mental health index (Pearson's correlation coefficient -0.48, p<0.05) and two subscales, i.e. "vitality" (Pearson's correlation coefficient -0.60, p<0.05) and "mental health" (Pearson's correlation coefficient -0.44, p<0.05). The most critical areas included physical pain and social limitations. The overall incidence of anxiety and depression was within normal limits according to the HADS test: LVAD patients supported for less than 1 year showed a lower incidence of anxiety compared with LVAD carriers supported for more than 1 year, while the incidence of depression was higher compared with LVAD carriers supported for more than 1 year. CONCLUSIONS: LVAD negatively impact physical and mental health, 'especially in older people; the scores obtained at SF-36, both for the physical health index and the mental health index, show lower average values than the regulatory standard. In addition, the depression levels vary based on the time elapsed from the date of implantation confirming the need for continuous monitoring of patients during treatment to prevent an increase of this index over the years. This patient subset requires continuing support and careful psychological monitoring, from preliminary assessment to LVAD implant, and later over the entire therapeutic process.
Subject(s)
Heart Failure , Heart-Assist Devices , Psychological Distress , Aged , Follow-Up Studies , Heart Failure/therapy , Humans , Quality of Life , Retrospective Studies , Treatment OutcomeABSTRACT
BACKGROUND: This study aims to investigate the quality of life and the therapeutic compliance of the patients who received a liver transplant, from a living or deceased donor, at IRCCS ISMETT in the last three years. Liver transplantation is an effective therapeutic strategy for patients with end-stage liver failure. The quality of life (QOL) of liver disease patients is placed under considerable stress due to the debilitating clinical conditions and related issues experienced in everyday life by these individuals. The concept of QOL is being increasingly used to define the individual perception of health, including physical, mental, and social wellbeing. The success of a liver transplant should therefore be intended not only in terms of survival, but also of recovery of a satisfying quality of life. For this reason, our liver transplant recipients are closely monitored and supported from a psychological standpoint. This is done to monitor their ability to adapt to and comply with their clinical condition and to verify their gradual resumption of their path of life Methods: We retrospectively analyzed data collected by the IRCCS ISMETT Clinical Psychology Service during routine psychological follow-up of liver transplant recipients. Data refer to 82 patients who received a liver transplant between January 2017 and September 2019 and describe their QOL and therapeutic adherence. The obtained results were compared with the main studies on this issue available in literature. RESULTS: Ninety-four percent of liver transplant recipients reported high mean scores of quality of life and therapeutic adherence 28% of patients reported at least one persistent annoying symptom after transplantation, although in some cases this did not affect the overall QOL. The results also refer to patients with a pre-transplant diagnosis of alcohol-related cirrhosis, who confirm their complete abstinence from alcohol. CONCLUSIONS: Our results confirm the efficacy of the liver transplantation to achieve of a good QOL. Furthermore, these patients seem to maintain high therapeutic adherence, thus ensuring a good outcome of the care received during the transplantation process.
