Perceived Need for Psychosocial Support After Aortic Dissection: Cross-Sectional Survey

Abstract

Background: The gold standard management of aortic dissection, a life-threatening condition, includes multidisciplinary approaches. Although mental distress following aortic dissection is common, evidence-based psychosocial interventions for aortic dissection survivors are lacking.

Objective: The aim of this study is to identify the perceived psychosocial needs of aortic dissection survivors by surveying patients, their relatives, and health professionals to inform the development of such interventions.

Methods: This study used a cross-sectional survey and collected responses from 41 participants (27 patients with aortic dissection, 8 relatives of patients with aortic dissection, and 6 health professionals) on key topics, types of interventions, best timing, anticipated success, and the intended effects and side effects of psychosocial interventions after aortic dissection.

Results: The principal intervention topics were "changes in everyday life" (28/41, 68%, 95% CI 54.5%-82.9%), "anxiety" (25/41, 61%, 95% CI 46.2%-76.2%), "uncertainty" (24/41, 59%, 95% CI 42.9%-73.2%), "tension/distress" (24/41, 59%, 95% CI 43.9%-73.8%), and "trust in the body" (21/41, 51%, 95% CI 35.9%-67.5%). The most commonly indicated intervention types were "family/relative therapy" (21/41, 51%, 95% CI 35%-65.9%) and "anxiety treatment" (21/41, 51%, 95% CI 35%-67.5%). The most recommended intervention timing was "during inpatient rehabilitation" (26/41, 63%, 95% CI 47.6%-77.5%) followed by "shortly after inpatient rehabilitation" (20/41, 49%, 95% CI 32.4%-65%). More than 95% (39/41) of respondents anticipated a benefit from psychosocial interventions following aortic dissection dissection, expecting a probable improvement in 68.6% (95% CI 61.4%-76.2%) of aortic dissection survivors, a worse outcome for 5% (95% CI 2.9%-7.9%), and that 6% (95% CI 1.8%-10.4%) would have negative side effects due to such interventions.

Conclusions: Our findings highlight a substantial need for psychosocial interventions in aortic dissection survivors and indicate that such interventions would be a success. They provide a basis for the development and evaluation of interventions as part of state-of-the-art aortic dissection management.

Keywords: aortic dissection; patient involvement; psychosocial support; psychosomatic; psychotherapy; treatment need.

Conflict of interest statement

Conflicts of Interest: None declared.

©Gunther Meinlschmidt, Denis Berdajs, Roger Moser-Starck, Alexander Frick, Sebastian Gross, Ulrich Schurr, Friedrich S Eckstein, Sabina Hunziker, Rainer Schaefert. Originally published in Journal of Participatory Medicine (http://jopm.jmir.org), 06.07.2020.

Figures

Figure 1

Frequency of subjects mentioning a certain concern or topic of interest to aortic dissection survivors to be addressed by psychosocial-psychotherapeutic interventions (mean and 95% CI). AOD: aortic dissection.

Figure 2

Frequency of subjects mentioning a certain type of psychosocial-psychotherapeutic intervention being of relevance to aortic dissection survivors (mean and 95% CI). AOD: aortic dissection.

Figure 3

Frequency of subjects proposing a certain time as appropriate for psychosomatic or psychotherapeutic support after aortic dissection (mean and 95% CI). AOD: aortic dissection.

Figure 4

Frequency of subjects agreeing that patients would benefit from psychotherapeutic support after aortic dissection (mean and 95% CI). AOD: aortic dissection.