scholarly journals Self-care behaviours mediate the effect of educational intervention on health-related quality of life of patients with heart failure: causal mediation analysis

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
B Hwang ◽  
H Yu ◽  
Y Jeong ◽  
H.-J Cho ◽  
H.-Y Lee
Keyword(s):  
Social Support ◽  
Educational Intervention ◽  
Indirect Effect ◽  
Self Care ◽  
Educational Interventions ◽  
Patients With Heart Failure ◽  
Related Quality ◽  
Health Related ◽  
And Gender

Abstract Background/Introduction Educational interventions have been developed and tested in an attempt to improve health-related quality of life (HRQOL) for patients with heart failure (HF). While some have shown satisfactory results, the mechanism of the intervention effect on HRQOL remains unclear. Purpose To explore whether HF knowledge, self-care behaviours, self-care maintenance, self-care confidence, or social support mediates the effect of intervention on HRQOL of patients with HF Methods We analysed data from a randomized controlled trial testing the effect of an educational intervention for patients with HF. The intervention group (n=60) received 1-hour single session education followed by 8-week telephone follow-ups, and the control group (n=62) received care as usual. Study variables were measured at baseline and at 3 and 6 months. Using causal mediation analysis described by Valeri & VanderWeele (2013), we explored the causal pathway between intervention allocation and HRQOL at 6 months with HF knowledge, self-care behaviours, self-care maintenance, self-care confidence, and social support measured at 3 months as potential mediators (Figure 1). Results Intervention allocation was significantly associated with HF knowledge, self-care behaviours, self-care maintenance, and self-care confidence at 3 months (all p<0.05), but not with social support at 3 months (p=0.57). In unadjusted models, none of the potential mediators had a significant indirect effect between intervention and HRQOL. When adjusting for age and gender, the indirect effect of self-care behaviours on 6-month HRQOL became significant (indirect effect −6.24, 95% CI: −12.88 to −1.18). When baseline values of the mediator and HRQOL were adjusted in addition to age and gender, the indirect effect of self-care behaviours remained significant (indirect effect −7.18, 95% CI: −13.48 to −2.35) and the indirect effect of self-care maintenance became significant (indirect effect −3.02, 95% CI: −7.94 to −0.07). Conclusion Our findings support the mediating role of self-care behaviours on the relationship between the educational intervention and HRQOL of patients with HF. In order to successfully improve HRQOL of patients with HF, educational interventions should aim to promote self-care behaviours, especially by encouraging treatment adherence and self-monitoring. FUNDunding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Seoul National University, College of Medicine Figure 1. Mediation model

Abstract 11916: Changes in Symptoms Predicted Changes in Health-Related Quality of Life in Patients With Heart Failure

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Seongkum Heo ◽  
Debra K Moser ◽  
Terry A Lennie ◽  
Mary Fischer ◽  
Eugene Smith ◽  
...  
Keyword(s):  
Heart Failure ◽  
Self Care ◽  
Physical Symptoms ◽  
Functional Class ◽  
Nyha Functional Class ◽  
Behavioral Variables ◽  
Patients With Heart Failure ◽  
Related Quality ◽  
Health Related

Background: Patients with heart failure (HF) have notably poor health-related quality of life (HRQOL), which is associated with high hospitalization rates. Physical symptoms have been associated with poor HRQOL. However, whether improvement in physical symptoms actually leads to improvement in HRQOL has not fully examined in patients with HF. Purpose: To examine the effects of changes in physical symptoms on changes in HRQOL at 12 months, after controlling for age, comorbidities, New York Heart Association (NYHA) functional class, and modifiable psychosocial and behavioral factors. Methods: Data on physical symptoms (Symptom Status Questionnaire-HF) and HRQOL (Minnesota Living with Heart Failure) were collected from 94 patients with HF (mean age 58 ± 14 years, 44% male, 58% NYHA functional class II/III) at baseline and 12 month follow-up. Age, comorbidities, and NYHA functional class were collected using standard questionnaires at baseline. Psychosocial variables (depressive symptoms [Patient Health Questionnaire], perceived control [Control Attitudes Scale-Revised], and social support [Multidimensional Scale of Perceived Social Support]) and behavioral variables (medication adherence [Micro-Electro-Mechanical Systems], sodium intake [24-hour urine], and self-care management [Self-care management subscale of the Self-Care of Heart Failure Index]) were collected at baseline. Hierarchical multiple regression analyses were used to analyze the data. Results: The mean score changes in physical symptoms and HRQOL were -3.8 (± 14.1) and -9.2 (± 24.1), respectively (negative scores indicate improvement.). Among the sociodemographic and clinical characteristics, psychosocial variables, behavioral variables, baseline physical symptoms, and changes in physical symptoms, only changes in physical symptoms predicted changes in HRQOL at 12 months (F = 6.384, R2 = .46, p < .001). Improvement in physical symptoms led to improvement in HRQOL. Conclusion: It is critical to improve physical symptoms to improve HRQOL. Thus, development and delivery of effective interventions targeting improvement in physical symptoms are warranted in this population.

scholarly journals P.049 Quality of life in children with absence epilepsy

2019 ◽  
Vol 46 (s1) ◽  
pp. S27
Author(s):  
M Sidhu ◽  
D Streiner ◽  
G Ronen
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Social Function ◽  
Absence Epilepsy ◽  
Social Subscale ◽  
Related Quality ◽  
Health Related ◽  
And Gender ◽  
Generalized Epilepsy

Background: Childhood absence epilepsy is a common generalized epilepsy in pediatric patients. Although this was considered a “benign” syndrome, new data suggests there are associated neurocognitive effects. This is the first study comparing quality of life and social functioning in those with absence epilepsy to those with other types of epilepsy. Methods: This observational study recruited patients from six Canadian academic centers. 106 patients had absence seizures, and 219 had other seizures. Established measures of depression, anxiety, social skills, social support, participation, quality of life, and epilepsy severity were assessed. MANCOVA was used to evaluate differences in social function, quality of life, and epilepsy severity measures, while accounting for age and gender. Results: This yielded a statistically significant result (Wilk’s lambda &lt;0.05), with partial eta squared of 0.163. Follow up of between subjects tests revealed lower health related quality of life interpersonal/ social subscale and close friend social support scores in those with absence epilepsy, while other measures were not significant. Conclusions: Children with absence epilepsy have similar social function, quality of life and epilepsy severity measures compared to those with other types of epilepsy. This indicates that any dysfunction in these domains is similar to those with other types of epilepsy.

Self-Care Behaviors, Symptom Status, and Health-Related Quality of Life in Patients with Heart Failure

2008 ◽  
Vol 14 (6) ◽  
pp. S106
Author(s):  
Seongkum Heo ◽  
Terry A. Lennie ◽  
Susan J. Pressler ◽  
Sandra B. Dunbar ◽  
Debra K. Moser ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Self Care ◽  
Health Related Quality ◽  
Patients With Heart Failure ◽  
Related Quality ◽  
Health Related ◽  
Symptom Status

Abstract 270: Prediction of Health-Related Quality of Life at 12 Months From Baseline Modifiable Factors in Patients With Heart Failure

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Seongkum Heo ◽  
Jinshil Kim ◽  
Debra K Moser ◽  
Terry A Lennie ◽  
Mary Fischer ◽  
...  
Keyword(s):  
Heart Failure ◽  
Care Management ◽  
Self Care ◽  
Functional Class ◽  
Nyha Functional Class ◽  
Modifiable Factors ◽  
Patients With Heart Failure ◽  
Related Quality ◽  
Health Related

Introduction: Patients with heart failure (HF) report that good health-related quality of life (HRQOL) is more valuable than longer survival, and improvement in HRQOL after discharge has been associated with lower rates of hospitalization. However, HRQOL in patients with HF is remarkably poorer than that in patients with other chronic diseases. To improve HRQOL effectively, it is critical to examine comprehensive modifiable predictors. However, to our knowledge, this has not been examined in patients with HF. Purpose: To examine baseline psychosocial, behavioral, and physical predictors of HRQOL at 12 months in patients with HF. Methods: We collected data on HRQOL at 12 months using the Minnesota Living with Heart Failure Questionnaire and other data at baseline from 94 patients with HF (mean age 58 ± 14 years). We collected data on all psychosocial variables, one behavioral variable, and one physical variable using questionnaires: depressive symptoms (Patient Health Questionnaire), perceived control (Control Attitudes Scale-Revised), social support (Multidimensional Scale of Perceived Social Support), self-care management (Self-care management subscale of the Self-Care of Heart Failure Index), and HF symptoms (Symptom Status Questionnaire-HF). We assessed one physical factor (New York Heart Association [NYHA] functional class) using in-depth interview. We assessed two behavioral factors using objective measures: medication adherence (Micro-Electro-Mechanical Systems) and sodium intake (24-hour urine). Covariates were age and comorbidity. Multiple regression analysis was used to address the purpose. Results: After controlling for covariates, among multidimensional psychosocial, behavioral, and physical variables, 3 modifiable factors (medication adherence [p = .001], HF symptoms [p = .011], and NYHA functional class [p < .001]) significantly predicted 12-month HRQOL (F = 11.853, R 2 = .59, p < .001). Conclusion: The findings of this study demonstrate multidimensional, modifiable predictors that interventions can target to improve HRQOL. Clinicians and researchers can target improvement in self-care, HF symptoms, and NYHA functional class to improve HRQOL, and, in turn, to reduce hospitalization rates.

Social support and health-related quality of life among type 2 DM (T2DM) patients attending a public hospital in Lagos, Nigeria

2019 ◽  
Author(s):  
Olufolake Olabode ◽  
Timothy Omoluru ◽  
Olawunmi Olagundoye ◽  
Akinyele Akinlade ◽  
Henry Akujobi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Public Hospital ◽  
Health Related Quality ◽  
Type 2 Dm ◽  
Related Quality ◽  
Health Related

Telemonitoring in Heart Failure Rehabilitation

2011 ◽  
Vol 7 (1) ◽  
pp. 66 ◽  
Author(s):  
Ewa Piotrowicz ◽  
Ryszard Piotrowicz ◽  
◽  
Keyword(s):  
Heart Failure ◽  
Cardiac Rehabilitation ◽  
Ecg Monitoring ◽  
Heart Rate Monitoring ◽  
Electrocardiographic Monitoring ◽  
Number Of Patients ◽  
Patients With Heart Failure ◽  
Related Quality ◽  
Health Related

Exercise training (ET) is now recommended as an important component of a comprehensive approach to patients with heart failure (HF). Despite the existence of proven benefits of ET, many HF patients remain physically inactive. Introducing telerehabilitation (TR) may eliminate most of the factors that result in the currently low number of patients undergoing outpatient-based rehabilitation programmes and thus increase the percentage of those who will undergo cardiac rehabilitation. Despite the fact that TR is highly applicable and effective, there are few papers dedicated to the study of TR in HF patients. Until recently, only a couple of home rehabilitation-monitoring models have been presented, from the simplest, i.e. heart rate monitoring and transtelephonic electrocardiographic monitoring, through to the more advanced tele-electocardiogram (tele-ECG) monitoring (via a remote device) and realtime electrocardiographic and voice transtelephonic monitoring. It seems the last two are the most useful and reliable. Based on published studies, TR in HF patients could be equally effective as and provide similar improvements in health-related quality of life to standard outpatient cardiac rehabilitation. In addition, adherence to cardiac rehabilitation seems to be better during TR. Due to disease-related limitations, TR seems to be a viable alternative for comprehensive cardiac rehabilitation in HF patients. Further studies are needed to confirm the utility of this type of rehabilitation in routine clinical practice, including its cost-effectiveness. Because of the diversity of technological systems, it is necessary to create a platform to ensure compatibility between the devices used in telemedicine.

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