Abstract 2234: Self-care And Quality Of Life In Patients With Heart Failure

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Chantira Chiaranai ◽  
Jeanne Salyer
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Decision Making ◽  
Self Care ◽  
Functional Class ◽  
Nyha Functional Class ◽  
Co Morbidity ◽  
Patients With Heart Failure ◽  
Disease Specific

Purpose: Although it is well-known that self-care (SC) reduces the frequency of hospital admissions and exacerbations, and enhances quality of life (QOL) in heart failure patients, little is known about SC in this population. The study purpose was to examine relationships among selected individual characteristics (demographics, severity of illness, co-morbidities, and social support), SC strategies, and QOL using Reigel’s Model of Self Care in Patients with Heart Failure as the guiding framework. Method: 114 subjects were recruited to participate in this descriptive correlational study. SC was measured using the Self-Care of Heart Failure Index , which measures self-care maintenance (SC-Mt), self-care management (SC-Mn), and self-care self-confidence (SC-Sc). QOL was measured using a disease-specific instrument, the Minnesota Living with Heart Failure Questionnaire , and a generic instrument, the Short-Form Health Survey characterizing physical and mental-emotional functioning. Multiple regression analysis was used to identify predictors of QOL. Findings: 98 subjects (age = 56.7 years; 53.8% male; 49.5% Caucasian) completed and returned mailed questionnaires. Multiple regression analyses demonstrated that better disease-specific QOL was predicted by being less likely to try SC-Mn strategies (β = .325; p = 0.003), better SC-Sc (β = −.251; p = 0.012), better NYHA functional class (β = .246; p = 0.008), and less co-morbidity (β = .236; p = 0.014) (R 2 = .334; F = 7.269, p = 0.000). Better generic QOL (physical functioning) was predicted by better NYHA functional class (β = −.309; p = 0.001), better SC-Mt (β = .205; p = 0.037), better SC-Sc (β = .296; p = 0.003), and being less likely to try SC-Mn strategies (β = −.165; p = 0.000) (R 2 = .361; F = 9.602, p = 0.000). Better generic QOL (mental-emotional functioning) was predicted by better NYHA functional class (β = −.229; p = 0.024), and being men (β = −.204; p = .047) (R 2 = .277; F = 4.548, p = 0.000). Discussion: Findings suggest that better QOL is influenced by gender (male), better NYHA functional class, less co-morbidity, and better use of SC strategies. Exploring patient decision-making can assist nurses in identifying how to improve decision-making performance and enhance QOL.

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.

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.

scholarly journals Does Symptom Recognition Improve Self-Care in Patients with Heart Failure? A Pilot Study Randomised Controlled Trial

2021 ◽  
Vol 11 (2) ◽  
pp. 418-429
Author(s):  
Joana Pereira Sousa ◽  
Hugo Neves ◽  
Miguel Pais-Vieira
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Care Management ◽  
Controlled Trial ◽  
Self Care ◽  
Fluid Restriction ◽  
Symptom Recognition ◽  
Patients With Heart Failure ◽  
Randomised Controlled

Patients with heart failure have difficulty in self-care management, as daily monitoring and recognition of symptoms do not readily trigger an action to avoid hospital admissions. The purpose of this study was to understand the impact of a nurse-led complex intervention on symptom recognition and fluid restriction. A latent growth model was designed to estimate the longitudinal effect of a nursing-led complex intervention on self-care management and quality-of-life changes in patients with heart failure and assessed by a pilot study performed on sixty-three patients (33 control, 30 intervention). Patients in the control group had a higher risk of hospitalisation (IRR 11.36; p < 0.001) and emergency admission (IRR 4.24; p < 0.001) at three-months follow-up. Analysis of the time scores demonstrated that the intervention group had a clear improvement in self-care behaviours (βSlope. Assignment_group = −0.881; p < 0.001) and in the quality of life (βSlope. Assignment_group = 1.739; p < 0.001). This study supports that a nurse-led programme on symptom recognition and fluid restriction can positively impact self-care behaviours and quality of life in patients with heart failure. This randomised controlled trial was retrospectively registered (NCT04892004).

A Correlational Study of Illness Knowledge, Self-Care Behaviors, and Quality of Life in Elderly Patients With Heart Failure

2014 ◽  
Vol 22 (2) ◽  
pp. 136-145 ◽  
Author(s):  
Min-Hui Liu ◽  
Chao-Hung Wang ◽  
Yu-Yen Huang ◽  
Wen-Jin Cherng ◽  
Kai-Wei Katherine Wang
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Elderly Patients ◽  
Self Care ◽  
Correlational Study ◽  
Illness Knowledge ◽  
Patients With Heart Failure

scholarly journals Psychosocial adaptation to chronic heart failure in patients with coronary heart disease

2021 ◽  
Vol 102 (2) ◽  
pp. 156-166
Author(s):  
A G Zhidyaevskij ◽  
G S Galyautdinov ◽  
V D Mendelevich ◽  
A G Gataullina ◽  
A O Kuzmenko
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Psychosocial Adaptation ◽  
Functional Class ◽  
Adherence To Treatment ◽  
Nyha Functional Class ◽  
Type D ◽  
Sf 36

Aim. To assess the effects of acquired social status, neurotic conditions, type D personality, cognitive functions, quality of life and adherence to treatment on psychosocial adaptation of patients with coronary heart disease (IHD) to chronic heart failure (CHF), depending on the severity of decompensation. Methods. 87 patients with coronary artery disease and chronic heart failure aged between 55 and 72 years were examined. All patients were divided into two groups depending on the functional class of chronic heart failure [New York Heart Association (NYHA) class IIV]. The first group included 41 patients with NYHA functional class III, the second group 46 patients with NYHA functional class IIIIV. For a comprehensive study of the psychosocial adaptation of patients, a set of standardized questionnaires was used: the abridged variant of the Minnesota Multiphasic Personality Inventory (SMOL), a clinical questionnaire for identifying and assessing neurotic condition, the Minnesota Living with Heart Failure Questionnaire (MLHFQ), the 36-Item Short Form Health Survey Questionnaire (SF-36), the Mini Mental State Examination (MMSE), 14-question test Type D Scale-14 (DS14), MoriskyGreen test, the short version of the AUDIT questionnaire (AUDIT-C). We collected data on the patient's social status: gender, education, income level. The results obtained were analyzed. Results. Based on the SMOL personality profiles, patients of the second group were classified as neurotic an increase was noted in three neurotic scales: hypochondria (U=541; p=0.030), hysteria (U=579; p=0.048), and autism/schizoid (U=577.5; p=0.047) compared with patients of the first group. According to the results of the clinical questionnaire for the identification and assessment of neurotic condition, the greatest differences were found between patients of first and second groups on the scale of autonomic disorders (U=571; p=0.039) and neurotic depression (U=576; p=0.046). Comparing the groups according to the MLHFQ score, quality of life in patients of the second group was markedly reduced (U=447.5; p 0.001). According to the SF-36 questionnaire, a decrease in the quality of life was also found in patients of the second group on the scale Physical functioning (U=554; p=0.032) and Physical component of health (U=573.5; p=0.044). The cognitive status in patients of the second group was significantly decreased compared with the first group (U=427; p 0.001). No significant differences were found in adherence to treatment between the two groups (U=757; p=0.666). Also, there were no patients with type D personality on both subscales (U=717.5; p=0.483, U=784; p=0.933) and according to the AUDIT-C scores, there are no significant differences between men (U=681.5; p=0.257) and women (U=728.5; p=0.425) in both groups of patients. Conclusion. Signs of social maladjustment in patients with more severe NYHA functional class of the disease are expressed by significantly more pronounced social isolation (autism), a tendency to avoid communicating with others, isolation on their own problems and hypochondriacal attention to the somatic manifestations of chronic heart failure; probably, the main reason that reduces the level of social adaptation is a high score in neuroticism, which leads to a functional decrease in cognitive abilities and a significant deterioration in quality of life.

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