Huang Zehao, Chair Sek Ying
The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China.
J Clin Nurs. 2025 Oct;34(10):4293-4300. doi: 10.1111/jocn.17653. Epub 2025 Jan 9.
Disease severity negatively affects health-related quality of life (HRQOL) among people with heart failure (HF). However, the underlying mechanisms remain underexplored. Illness perceptions and depression serve as potential mediators of this relationship, but the evidence supporting this is limited.
To investigate the relationships among disease severity, illness perceptions, depression and HRQOL in people with HF, as well as to explore the mediating roles of illness perceptions and depression in the relationship between disease severity and HRQOL.
People with HF were recruited from a tertiary hospital in China between January and May 2023. All the participants were assessed for disease severity, illness perceptions, depression, HRQOL and sociodemographic and clinical characteristics. The mediation analysis was performed using PROCESS macro in SPSS. The STROBE checklist was followed.
This study recruited 164 subjects. Disease severity had a significant total effect on HRQOL (β = 0.716, 95% CI: 4.475, 12.068). The results showed that illness perceptions mediated the relationship between disease severity and HRQOL (β = 0.172, 95% CI: 0.042, 0.337), accounting for 24.02% of the total effect. However, a significant mediating role of depression in this relationship was not found. Furthermore, we found that illness perceptions and depression sequentially mediated the relationship between disease severity and HRQOL (β = 0.194, 95% CI: 0.005, 0.395), which accounted for 27.09% of the total effect.
The effect of disease severity on HRQOL is sequentially mediated by illness perceptions and depression. Illness perceptions are important predictors of HRQOL. Targeted interventions should be employed to improve illness perceptions, thereby enhancing HRQOL among people with HF.
Medical staff can carefully assess patient's illness perceptions and implement appropriate strategies to enhance these illness perceptions, thereby improving their HRQOL.
No patient or public contribution.
疾病严重程度会对心力衰竭（HF）患者的健康相关生活质量（HRQOL）产生负面影响。然而，其潜在机制仍未得到充分探索。疾病认知和抑郁可能是这种关系的潜在中介因素，但支持这一观点的证据有限。
研究HF患者的疾病严重程度、疾病认知、抑郁和HRQOL之间的关系，并探讨疾病认知和抑郁在疾病严重程度与HRQOL关系中的中介作用。
于2023年1月至5月在中国一家三级医院招募HF患者。对所有参与者进行疾病严重程度、疾病认知、抑郁、HRQOL以及社会人口学和临床特征的评估。使用SPSS中的PROCESS宏进行中介分析。遵循STROBE清单。
本研究共招募了164名受试者。疾病严重程度对HRQOL有显著的总体效应（β = 0.716，95%CI：4.475，12.068）。结果表明，疾病认知介导了疾病严重程度与HRQOL之间的关系（β = 0.172，95%CI：0.042，0.337），占总体效应的24.02%。然而，未发现抑郁在这种关系中具有显著的中介作用。此外，我们发现疾病认知和抑郁依次介导了疾病严重程度与HRQOL之间的关系（β = 0.194，95%CI：0.005，0.395），占总体效应的27.09%。
疾病严重程度对HRQOL的影响依次由疾病认知和抑郁介导。疾病认知是HRQOL的重要预测因素。应采取针对性干预措施来改善疾病认知，从而提高HF患者的HRQOL。
医务人员可以仔细评估患者的疾病认知，并实施适当策略来增强这些疾病认知，从而改善他们的HRQOL。
无患者或公众贡献。
