This research was conducted as a descriptive study to identify the factors influencing health-related quality of life in patients with heart failure using Rector’s conceptual model of quality of life relation to heart failure. The participants in th...
This research was conducted as a descriptive study to identify the factors influencing health-related quality of life in patients with heart failure using Rector’s conceptual model of quality of life relation to heart failure. The participants in this study were 165 patients with heart failure from A university medical center located in Suwon, South Korea. The data were collected via structured surveys and physical examinations performed between July 23 and September 15, 2021 after approval of IRB.
Health-related Quality of Life was measured using the Korean version of the Minnesota Living with Heart Failure questionnaire(MLHFQ) developed by Rector et al. (1987). Regarding influencing factors, symptoms were measured using the Korean version of the Heart Failure Symptom Checklist by Friedman(2003), and functional limitations were measured using the Korean Activity Scale/Index (KASI) by Seong(2000).
To measure psychological distress, the Korean version of the distress thermometer(DT) and problem list(PL) that was translated by Kim (2009) were used, and depression was measured using the Korean version of the Center for Epidemiologic Studies Depression Scale (CES-D) by Radloff (1977). The Korean version of the Medical Outcomes Study Social Support Survey (MOS-SSS) translated by Lim (2002) was used to measure social support.
The collected data were analyzed using the IBM SPSS Statistics 25.0 program. The measured variables were analyzed through descriptive statistics, an independent t-test, a one-way ANOVA, Pearson’s correlation coefficient, and hierarchical multiple regression analysis.
The main results of this study are as follows.
1. The mean score of participants’ health-related quality of life was 24.32 points(score range:0-105, with lower scores indicating higher levels of QoL), suggesting a moderate or high health-related quality of life. Regarding influencing factors, the mean scores of symptoms and functional limitations were low, at 4.32 point (maximum of 13) and 43.89 point (maximum of 77), respectively, while the score for social support was 75.58 point (maximum of 100), indicating a moderate or high level. Regarding psychological distress, the mean score of depression was 16.81 point (maximum of 60), which is close to the cut-off (16 point of higher), and the mean scores of distress were low at 3.41 point (maximum of 10) on the DT and 6.31 point (maximum of 24) on the PL.
2. In the univariate analysis of the correlation of health-related quality of life with general and disease-related characteristics, a significant variation in health-related quality of life was found for gender (t=-3.059, p=.003), age (t=-6.792, p<.001), education (t=8.677, p<.001), marital status (F=14.078, p<.001), presence or absence of spouse (t=-2.708, p=.007), occupation (t=-7.350, p<.001), monthly income (t=3.182, p=.002), subjective economic status (F=5.153, p=.007), single dose drug (t=-3.959, p<.001), relative grip strength (t=5.025, p=.002), calf circumference (F=12.331, p<.001), LVEF (t=2.360, p=.019), NYHA class (F=132.136, p<.001), Dyspnea-Fatigue Index (t=12.824, p<.001), and Charlson Comorbidity Index (t=-3.119, p=.002).
3. Health-related quality of life showed a significantly positive correlation with the main influencing factors of symptoms (r=.586, p<.001) and psychological distress (CES-D r=.712, p<.001, DT r=.423, p<.001, PL r=.671, p<.001) and a significantly negative correlation with functional limitations (r=-.756, p<.001) and social support (structural support r=-.370, p<.001, functional support r=-.226, p=.001).
4. The final regression model after the adjustment of variables with a significant result in the univariate analysis showed that the significant influencing factors of health-related quality of life were symptoms (β=120, p=.034), functional limitations (β=-.351, p<.001), and psychological distress (depression β=322, p<.001, distress β=.112, p=.038). The final regression model had an explanatory power of 72% for health-related quality of life (R2=.747, adjusted R²=.721; F=29.261, p<.001).
The findings in this study show that the significant influencing factors of health-related quality of life in patients with heart failure are symptoms, functional limitations, and psychological distress. Based on these findings, an intervention program should be developed to alleviate symptoms in patients with heart failure, enhance their physical functions, and moderate their psychological distress with an ultimate goal of enhancing their health-related quality of life. For this, a prospective study should be conducted.