The predictive value of self-compassion for psychological adjustment in left ventricular assist device patients: an observational study

Abstract

Aims: Implantation of a left ventricular assist device (LVAD) is an established treatment option for patients with advanced heart failure. However, apart from its challenging medical management, it comes with serious psychological implications. Empirical evidence suggests that self-compassion, a self-regulation strategy for countering negative self-directed emotions, might be a promising approach in facilitating psychological adjustment also in LVAD patients. The aims of the present study were to investigate self-compassion as a protective factor for anxiety and depressive symptoms, to test whether taking a decentred perspective mediates these effects, and to explore whether self-compassion predicts the clinically rated functional health status.

Method and results: A sample of N = 45 patients (36 male) with a mean age of 60.5 years (SD = 10.8) from the outpatient department for terminal heart failure at the University Medical Center in Kiel, Germany, participated in the study. Patients completed self-report measures for psychological adjustment (HADS), self-compassion (SCS), and decentring (EQ). Functional health status was determined by the NYHA classification. The more patients were self-compassionate, the less they reported anxiety (r = -0.28) and depressive symptoms (r = -0.34). Decentring mediated both effects. Moreover, self-compassion predicted the functional health status, even when controlling for anxiety (odds ratio [OR] = 0.09) and depressive symptoms (OR = 0.11).

Conclusions: This study provides the first evidence for a significant interrelation between self-compassion and common adverse psychological conditions in LVAD patients. Longitudinal data and the evaluation of interventions to strengthen self-compassion are needed to further validate the beneficial effects of self-compassion in LVAD patients in the future.

Keywords: Anxiety; Depression; Functional health status; Heart failure; LVAD; Self-compassion.