Jonathan P. Auld, MS, MAT, RN PhD Candidate, School of Nursing, Oregon Health & Science University, Portland. James O. Mudd, MD Associate Professor, Knight Cardiovascular Institute, Oregon Health & Science University, Portland. Jill M. Gelow, MD, MPH Assistant Professor, Knight Cardiovascular Institute, Oregon Health & Science University, Portland. Shirin O. Hiatt, MPH, MS, RN Research Project Coordinator, School of Nursing, Oregon Health & Science University, Portland. Christopher S. Lee, PhD, RN, FAHA, FAAN, FHFSA Associate Professor, School of Nursing, Knight Cardiovascular Institute, Oregon Health & Science University, Portland.
J Cardiovasc Nurs. 2018 May/Jun;33(3):217-224. doi: 10.1097/JCN.0000000000000447.
Physical symptoms and depression in heart failure (HF) are key drivers of health-related quality of life (HRQOL). Heart failure self-care behaviors are believed to influence how symptoms affect HRQOL.
The goal of this study was to determine if HF self-care behaviors moderate the relationships between physical and depressive symptoms and HRQOL.
In a cohort of adults with moderate to advanced HF, multivariate linear regression was used to evaluate the interaction between self-care behaviors (Self-care of HF index maintenance and management scales) and physical HF symptoms (HF Somatic Perception Scale) on emotional HRQOL (emotional dimension of Minnesota Living With HF Questionnaire). The interaction between self-care behaviors and depression (9-item Patient Health Questionnaire) was evaluated on physical HRQOL (physical dimension of Minnesota Living With HF Questionnaire).
The mean age of the sample (N = 202) was 57 ± 13 years, 50% were women, and 61% had New York Heart Association class III or IV HF. Controlling for age, Seattle HF score, functional ability, and comorbidities, self-care maintenance and management moderated the relationship between physical HF symptoms and emotional HRQOL. Only self-care maintenance moderated the relationship between depression and physical HRQOL.
In HF, HRQOL is dependent on both the severity of physical and depressive symptoms and the level of engagement in HF self-care behaviors. Future research should consider both self-care behaviors and symptoms when examining patient HRQOL.
心力衰竭（HF）中的身体症状和抑郁是影响健康相关生活质量（HRQOL）的关键因素。心力衰竭自我护理行为被认为会影响症状对 HRQOL 的影响。
本研究的目的是确定 HF 自我护理行为是否能调节身体和抑郁症状与 HRQOL 之间的关系。
在一组患有中重度 HF 的成年人中，采用多元线性回归来评估自我护理行为（HF 自我护理指数维持和管理量表）与身体 HF 症状（HF 躯体知觉量表）之间的相互作用，对情绪 HRQOL（明尼苏达州心力衰竭生活问卷的情绪维度）的影响。还评估了自我护理行为和抑郁（9 项患者健康问卷）之间的相互作用对身体 HRQOL（明尼苏达州心力衰竭生活问卷的身体维度）的影响。
样本的平均年龄（N=202）为 57±13 岁，50%为女性，61%有纽约心脏协会 III 或 IV 级 HF。在控制年龄、西雅图心力衰竭评分、功能能力和合并症后，自我护理维持和管理调节了身体 HF 症状与情绪 HRQOL 之间的关系。只有自我护理维持调节了抑郁与身体 HRQOL 之间的关系。
在 HF 中，HRQOL 既取决于身体和抑郁症状的严重程度，也取决于 HF 自我护理行为的参与程度。未来的研究在检查患者的 HRQOL 时，应同时考虑自我护理行为和症状。
