Carels Robert A
Department of Psychology, Bowling Green State University, Bowling Green, OH 43403, USA.
Qual Life Res. 2004 Feb;13(1):63-72. doi: 10.1023/B:QURE.0000015301.58054.51.
Congestive heart failure significantly compromises quality of life by contributing to severe physical, role, and social functioning impairment as well as increased psychological distress. Previous research examining quality of life in CHF patients has typically been conducted using global self-report instruments that may exceed a patient's ability to accurately recall their experiences. This investigation examines the impact of disease severity, functional status, and level of depression on daily quality of life (i.e., mean level and variability) in CHF patients during a 2-week monitoring period. Indices of quality of life included emotional and physical quality of life, social support and conflict, positive and negative mood, and coping responses. Fifty-eight patients with CHF participated in the investigation. Depressive symptoms were positively associated with a number of quality of life indices (i.e., physical and emotional quality of life, social support and conflict, mood, and coping behaviours). Left ventricular ejection fraction and functional impairment had a much weaker association with quality of life. These findings suggest that depressive symptoms may have a greater impact on quality of life in CHF patients than severity of cardiac dysfunction or functional impairment.
充血性心力衰竭会导致严重的身体、角色和社会功能障碍以及心理困扰增加,从而严重损害生活质量。以往关于慢性心力衰竭(CHF)患者生活质量的研究通常使用整体自我报告工具,而这些工具可能超出了患者准确回忆自身经历的能力。本研究考察了在为期2周的监测期内,疾病严重程度、功能状态和抑郁水平对CHF患者日常生活质量(即平均水平和变异性)的影响。生活质量指标包括情绪和身体生活质量、社会支持与冲突、积极和消极情绪以及应对反应。58名CHF患者参与了该研究。抑郁症状与多个生活质量指标呈正相关(即身体和情绪生活质量、社会支持与冲突、情绪和应对行为)。左心室射血分数和功能损害与生活质量的关联则弱得多。这些发现表明,抑郁症状对CHF患者生活质量的影响可能比心脏功能障碍或功能损害的严重程度更大。