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[Disease-specific quality of life in primary care patients with heart failure]
Martin Scherer1, Beate Stanske, Dirk Wetzel
1Abteilung AlIgemeinmedizin, Georg-August-Universität Göttingen. mschere@gwdg.de
Background:
Quality of Life (QoL) is an important predictor of mortality and re-admission in patients with heart failure (HF). Our aim was to analyze disease-specific quality of life and its relationship to psycho-social factors and HF severity.
Methods:
In primary care patients with HF, quality of life (MLHFQ), anxiety, depression (HADS) and negative affectivity (DS-14), disease coping (FKV) and social support (F-SozU) were measured by validated questionnaires. Severity of HF (according to NYHA classification and Goldman's Specific Activity Scale) and sociodemographic characteristics were documented by self-report instruments.
Results:
363 patients from 44 general practices participated in the study (191 [52.6%] female). Women had more physical but not more emotional problems than men. Increased emotional and physical problems and global disease-related impairment in QoL (F = 63.29; p < 0.001) correlated with higher HF classes. Using regression analysis, more than 50% of the QoL values were predicted by psychological variables and perceived severity (significant for depression [HADS; p < 0.001], coping by dissimulation and wishful thinking [FKV; p = 0.027], HF severity [NYHA, Goldman;
Conclusion:
Psychosocial distress is a strong predictor of QoL impairment in primary care patients with HF. Because of its impact on both long-term prognosis and disease-specific QoL, psychosocial symptoms should be considered essential for the diagnosis and therapy in the routine care of patients with HF.
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Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...