Akintade Bimbola Fola, Chapa Deborah, Friedmann Erika, Thomas Sue Ann
Bimbola Fola Akintade, PhD, ACNP-BC, MBA, MHA Assistant Professor and Specialty Director, Adult Gerontological Acute Care Nurse Practitioner/Clinical Nurse Specialist Program, School of Nursing, University of Maryland, Baltimore. Deborah Chapa, PhD, ACNP-BC Assistant Professor, School of Nursing, George Washington University, Washington, DC. Erika Friedmann, PhD Professor, School of Nursing, University of Maryland, Baltimore. Sue Ann Thomas, PhD, RN, FAAN Professor and Assistant Dean, PhD Program, School of Nursing, University of Maryland, Baltimore.
J Cardiovasc Nurs. 2015 Jan-Feb;30(1):66-73. doi: 10.1097/JCN.0000000000000107.
The health-related quality of life (HRQoL) of patients with atrial fibrillation (AF) and atrial flutter (AFL) is an important issue in cardiovascular health management. Determinants of poor HRQoL of AF/AFL patients require further elucidation.
The purpose of this study was to evaluate the influencing factors related to the HRQoL of AF/AFL patients.
In 150 consecutively recruited patients in a multicenter, cross-sectional study from April 2010 to February 2011, depression and anxiety were measured with the Beck Depression Inventory II and the State Trait Anxiety Inventory, respectively, whereas HRQoL was assessed with the generic Medical Outcomes Survey 36-Item Short-Form Survey version 2 and the Symptom Checklist. Linear regression modeling was performed to determine predictors of HRQoL among variables, including the patients' age, gender, race, marital status, type of AF/AFL, frequency of AF/AFL symptoms, time since diagnosis, and anxiety and depression symptoms.
Female patients with AF/AFL reported poorer physical HRQoL than male patients did (P < .001, R² = 0.391). Symptoms of depression and anxiety were found to be associated with poorer HRQoL (P < .001, R² = 0.482). Anxiety was the strongest predictor of the mental component of the Medical Outcomes Survey 36-Item Short-Form Survey version 2 and the Symptom Checklist. Younger patients had worse AF/AFL-related symptoms and severity than older patients did (P < .001, R² = 0.302). Increased frequency of symptomatic episodes was associated with worse AF/AFL-related symptoms and severity.
In conclusion, depression and anxiety symptoms and female gender emerged as clear indicators of poor HRQoL in AF/AFL patients. These risk factors should be used to identify patients who may require additional evaluation and treatment efforts to manage their cardiac conditions or HRQoL. Interventions to improve HRQoL in these individuals require further investigation.
心房颤动（AF）和心房扑动（AFL）患者的健康相关生活质量（HRQoL）是心血管健康管理中的一个重要问题。AF/AFL患者HRQoL较差的决定因素需要进一步阐明。
本研究旨在评估与AF/AFL患者HRQoL相关的影响因素。
在2010年4月至2011年2月进行的一项多中心横断面研究中，连续招募了150例患者，分别用贝克抑郁量表第二版和状态特质焦虑量表测量抑郁和焦虑，而HRQoL则用通用的医学结局调查36项简表第2版和症状清单进行评估。进行线性回归建模以确定变量中HRQoL的预测因素，包括患者的年龄、性别、种族、婚姻状况、AF/AFL类型、AF/AFL症状频率、诊断后的时间以及焦虑和抑郁症状。
AF/AFL女性患者报告的身体HRQoL比男性患者差（P <.001，R² = 0.391）。发现抑郁和焦虑症状与较差的HRQoL相关（P <.001，R² = 0.482）。焦虑是医学结局调查36项简表第2版和症状清单心理成分的最强预测因素。年轻患者比老年患者有更差的AF/AFL相关症状和严重程度（P <.001，R² = 0.302）。有症状发作频率增加与更差的AF/AFL相关症状和严重程度相关。
总之，抑郁和焦虑症状以及女性性别是AF/AFL患者HRQoL差的明确指标。这些危险因素应用于识别可能需要额外评估和治疗以管理其心脏状况或HRQoL的患者。改善这些个体HRQoL的干预措施需要进一步研究。
