Seongkum Heo, PhD, RN Associate Professor, College of Nursing, University of Arkansas for Medical Sciences, Little Rock. Debra K. Moser, PhD, RN, FAAN Professor, College of Nursing, University of Kentucky, Lexington. Terry A. Lennie, PhD, RN Professor, College of Nursing, University of Kentucky, Lexington. Mary Fischer, MSN, RN Clinical Nurse Specialist, St Vincent Hospital, Indianapolis, IN. JinShil Kim, PhD, RN Professor, College of Nursing, Gachon University, Incheon, South Korea. Mikyoung Lee, PhD, RN Associate Professor, College of Nursing, Texas Woman's University, Denton. Mary N. Walsh, MD Cardiologist, St Vincent Hospital, Indianapolis, IN. Songthip Ounpraseuth, PhD College of Public Health, University of Arkansas for Medical Sciences, Little Rock.
J Cardiovasc Nurs. 2018 Sep/Oct;33(5):460-466. doi: 10.1097/JCN.0000000000000493.
Patients with heart failure (HF) have notably poor health-related quality of life (HRQOL). A 5-point improvement in HRQOL is associated with reduction in hospitalization and mortality rates. Heart failure symptoms are associated with poor HRQOL, but little is known about whether changes in HF symptoms lead to changes in HRQOL over time. Therefore, we examined the association of changes in HF symptoms with changes in overall, physical, and emotional aspects of HRQOL over a 12-month period, controlling for typical covariates.
Data on HF symptoms and HRQOL (Minnesota Living Heart Failure questionnaire) were collected from 94 patients with HF (mean age, 58 years; 58.5% female) at baseline and 12-month follow-up. Psychosocial factors (depressive symptoms, perceived control, and social support), behavioral factors (medication adherence and sodium intake), sociodemographic and clinical factors (age, comorbidities, and body mass index), and a physical factor (functional status) were collected at baseline. Multiple and logistic regression analyses were used to analyze the data.
In complete models, changes in HF symptoms were associated with changes in the total HRQOL (P < .001) and the physical (P < .001) and emotional (P < .001) aspects of HRQOL over 12 months, controlling for all the factors. Changes in HF symptoms were significantly associated with the likelihood of at least a 5-point improvement in HRQOL (P = .001), controlling for covariates.
Improvement in HF symptoms was associated with improvement in HRQOL over 12 months. Thus, development and delivery of interventions that target improvement in HF symptoms may improve HRQOL.
心力衰竭（HF）患者的健康相关生活质量（HRQOL）明显较差。HRQOL 提高 5 分与住院率和死亡率的降低相关。HF 症状与较差的 HRQOL 相关，但对于 HF 症状的变化是否会随着时间的推移导致 HRQOL 的变化知之甚少。因此，我们考察了在 12 个月的时间内，HF 症状的变化与 HRQOL 的整体、生理和心理方面的变化之间的关联，同时控制了典型的协变量。
从 94 名 HF 患者（平均年龄 58 岁；58.5%为女性）基线和 12 个月随访时收集 HF 症状和 HRQOL（明尼苏达生活心力衰竭问卷）的数据。在基线时还收集了心理社会因素（抑郁症状、感知控制和社会支持）、行为因素（药物依从性和钠摄入量）、社会人口学和临床因素（年龄、合并症和体重指数）以及身体因素（功能状态）。使用多元和逻辑回归分析来分析数据。
在完整模型中，HF 症状的变化与 HRQOL 的总体变化（P<0.001）以及生理（P<0.001）和心理（P<0.001）方面的变化相关，控制了所有因素。HF 症状的变化与 HRQOL 至少提高 5 分的可能性显著相关（P=0.001），控制了协变量。
HF 症状的改善与 12 个月内 HRQOL 的改善相关。因此，开发和提供针对改善 HF 症状的干预措施可能会改善 HRQOL。
