Kraai I H, Vermeulen K M, Hillege H L, Jaarsma T
Department of Cardiology, University Medical Center Groningen, University of Groningen, the Netherlands
Department of Epidemiology, University Medical Center Groningen, University of Groningen, the Netherlands.
Eur J Cardiovasc Nurs. 2016 Apr;15(2):178-85. doi: 10.1177/1474515115621194. Epub 2015 Dec 11.
One of the major aims in the treatment of patients with heart failure (HF) is symptom relief and an improvement in the health-related quality of life (HR-QoL). The perception of impairments due to HF may differ between patients. A knowledge of the prevalence and perceived harshness of impairments due to HF is essential in providing personalized care on a patient level, in optimizing care on a population level and in finding the most appropriate patient-reported outcome for clinical trials.
The aim of this study was to explore the prevalence and perceived harshness of impairments due to HF and the relation between perceived harshness and HR-QoL in patients with HF.
The prevalence of impairments due to HF was assessed using items of the Minnesota Living with Heart Failure Questionnaire and the degree of perceived harshness was assessed using a structured self-assessment. A total of 100 outpatients (mean±SD age 70±9 years, 71% men) from an HF outpatient clinic were included. The prevalence of impairments was between 18 and 77%. The most prevalent impairments included tiredness and impairments in physical activity. Impairments that were frequently perceived as severely harsh included tiredness (67%), dyspnoea (57%) and impairments in physical activity (55%). Corrected item-total correlation (range 0.10-0.59) showed that tiredness (r=0.54) and impairments related to resting (r=0.59) and to participation in physical (r=0.52) and social (r=0.55) activities contributed highly to the sum-score of the Minnesota Living with Heart Failure Questionnaire.
Highly prevalent impairments are not by definition perceived as severely harsh by patients with HF and do not contribute to the overall HR-QoL except for the impairments tiredness and working around the house/yard. These insights are important in providing personalized and optimized care for patients with HF.
心力衰竭(HF)患者治疗的主要目标之一是缓解症状并改善健康相关生活质量(HR-QoL)。HF导致的功能障碍在患者中的认知可能存在差异。了解HF导致的功能障碍的患病率和感知严重程度对于在个体患者层面提供个性化护理、在人群层面优化护理以及为临床试验找到最合适的患者报告结局至关重要。
本研究的目的是探讨HF患者中HF导致的功能障碍的患病率和感知严重程度,以及感知严重程度与HR-QoL之间的关系。
使用明尼苏达心力衰竭生活问卷的条目评估HF导致的功能障碍的患病率,并使用结构化自我评估评估感知严重程度。共纳入了100名来自HF门诊的门诊患者(平均±标准差年龄70±9岁,71%为男性)。功能障碍的患病率在18%至77%之间。最常见的功能障碍包括疲劳和身体活动功能障碍。经常被认为严重的功能障碍包括疲劳(67%)、呼吸困难(57%)和身体活动功能障碍(55%)。校正后的项目总分相关性(范围0.10 - 0.59)表明,疲劳(r = 0.54)以及与休息(r = 0.59)、参与体育(r = 高)和社交(r = 0.55)活动相关的功能障碍对明尼苏达心力衰竭生活问卷的总分贡献很大。
HF患者并不一定认为高患病率的功能障碍严重,除了疲劳和在家中/院子里干活的功能障碍外,这些功能障碍对总体HR-QoL没有影响。这些见解对于为HF患者提供个性化和优化护理很重要。