Improving dyadic quality of life for left ventricular assistive devices patients and caregivers: Rationale & design of the Compassion Strikes Back pilot.

Background: When considering implanting a left ventricular assistive device (LVAD), the ability to care for and maintain the device requires significant levels of personal investment, medical care, and emotional resilience. The availability of a caregiver support is also critical to long-term success. Adaptation to life with LVAD includes several challenges from both caregiver and patients' perspectives, creating a bidirectional interaction and creation of dyads. Dyads with protective social support and coping fare better psychologically, which serving as a proxy for improved physical health outcomes. Self-compassion interventions have been shown to be beneficial across various settings for improving psychological outcomes in chronically ill patients and caregivers. Both dyadic coping and self-compassion interventions have limited extant research examining these concepts in the LVAD space. The Compassion Strikes Back Pilot Study explores the feasibility, acceptability, and efficacy of a brief psychosocial intervention within an integrated care setting aimed at improving quality of life for LVAD dyads during early home adaptation. Methods: 12 LVAD dyads will be randomized to control or a clinical psychologist led self-compassion intervention. Results: Primary outcomes of interest include the feasibility and acceptability of the intervention, as well as whether the intervention increases quality of life in the immediate post-LVAD home discharge phase. Other outcome measures include perceived stress, cardiac and general self-efficacy, illness denial, and caregiver burden. Conclusion: This pilot study aims to explore the feasibility and acceptability of such an intervention to improve outcomes for LVAD dyads in the early home adaptation phase. Clinical trial registration: NCT06988995.