Year of Publication

2021

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Evelyn Parrish

Clinical Mentor

Dr. Andrew Kolodziej

Committee Member

Dr. Sheila Melander

Committee Member

Dr. Lacey Buckler

Abstract

PURPOSE: The purpose of the Doctor of Nursing Practice (DNP) project was to pilot Creating Opportunities for Personal Empowerment (COPE), an evidence based cognitive behavioral therapy (CBT) intervention, with patients diagnosed with advanced heart failure who are awaiting Left Ventricular Assist Device (LVAD) implantation or those who have had one recently implanted before they are discharged home. METHODS: A cross-sectional study design was used for this Pilot project. Patients were identified for potential participation by LVAD coordinators and represent a convenience sample. The patients were screened for anxiety and depression using the GAD-7 and PHQ-9 screening tools. If patients scored a 5 or greater on either tool, they received the COPE CBT intervention. COPE is a 7 session CBT intervention with each session lasting 20-30 minutes, delivered every three to four days during the patient’s hospitalization following LVAD implantation when patient was able to participate. After the sessions were completed, patients were re-evaluated for depression and anxiety symptoms with GAD-7 and PHQ-9 tools. RESULTS: Five patients were able to participate during the timeframe of this Pilot Project. The average scores for depression and anxiety symptoms pre-intervention were 10.6 and 10.2, respectively. Post intervention, the scores decreased to an average of 5.4 and 3.2, respectively. Due to the small sample size the results did not reach statistical significance. Qualitative data reported from the participants suggests that they felt the intervention was helpful. CONCLUSION: Though the results did not achieve statistical significance, the decreases in average score represent clinically-significant decreases in depression and anxiety symptoms. More research is needed to confirm statistical and clinical significance of these findings. This COPE with LVAD Patients project does show that it is possible to implement a multi-session CBT intervention with advanced heart failure patients who have recently received LVAD implantation.

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