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[Emotional status of patients on the waiting list for heart transplantation]
1Medizinische Universitätsklinik, innere Medizin II, Schwerpunkt Allgemeine Klinische, und Psychosomatische Medizin, Heidelberg.
Insights
Patients awaiting heart transplantation experience significantly lower quality of life and higher depression and anxiety. This highlights the need for psychological support during the stressful waiting period for end-stage heart failure patients.
Area of Science:
- Cardiology
- Psychology
- Transplantation Medicine
Context:
- Declining organ donation rates lead to longer waiting times for heart transplantation.
- Patients with terminal heart failure face prolonged periods on the waiting list.
Purpose:
- To assess the quality of life and emotional state of patients awaiting heart transplantation.
- To investigate the psychological impact of extended waiting periods for donor organs.
Summary:
- Patients on the heart transplant waiting list reported significantly lower physical and psychological quality of life compared to healthy controls.
- Elevated levels of depression and anxiety were observed in patients awaiting heart transplantation.
- A significant correlation was found between dyspnea, a key symptom of heart failure, and depression levels.
Impact:
- Findings underscore the critical need for psychotherapeutic interventions for heart failure patients on waiting lists.
- Emphasizes the interconnectedness of psychological and somatic health in severely ill patients.
- Suggests that addressing psychological distress can improve patient well-being during the transplant waiting period.
Abstract:
Although heart transplantation is by now considered an established procedure in patients with terminal heart failure, there has been a stagnation or even a decline in the number of transplantations performed due to the decreased willingness of the public to provide organs. As a consequence of this development patients have to wait for a donor organ for a much larger time. The aim of this study was to examine patients especially during this very stressful period. From July 1995 to February 1997, 62 patients who had been continuously added to the waiting list were examined regarding their quality of life and emotional state. Completely assessed were 53 patients (participation rate: 85%). As compared to a healthy control group, patients with terminal heart failure on the waiting list reported their quality of life in the physical as well as the psychological area as significantly lower (p < 0.001). The areas of depression (p < 0.001) and anxiety (p < 0.001) also showed a significant difference. There was an obvious correlation (p < 0.01) between the key symptom of terminal heart failure-- dyspnoea--and the measured level of depression. This served to support the notion that there is a connection between the psychological and the somatic state in these severely ill patients. These results point to the necessity of supportive psychotherapeutic treatment during this very stressful time.