Depression and Disease Severity as Predictors of Health-Related Quality of Life in Patients With Chronic Heart Failure-A Structural Equation Modeling Approach
Depression and Disease Severity as Predictors of Health-Related Quality of Life in Patients With Chronic Heart Failure-A Structural Equation Modeling Approach
复制标题
DOI：
10.1016/j.cardfail.2008.10.022
复制
发表时间：
2009-05-01
影响因子：
6
通讯作者：
Angermann, Christiane E.
中科院分区：
文献类型：
--
作者：
Faller, Hermann;Stoerk, Stefan;Angermann, Christiane E.
背景资料：为了研究抑郁症和心力衰竭的严重程度是否是独立的预测因素的身体和心理领域的健康相关的生活质量（HRQoL）在patients with chronic heartful.Methods和Results：一个样本的206例门诊慢性心力衰竭（平均年龄64岁，69%的男性）进行了评估。采用患者健康问卷测量抑郁，采用堪萨斯城心肌病问卷测量疾病特异性HRQoL。心力衰竭的严重程度用纽约心脏协会（NYHA）心功能分级的医生评级进行评估。预测变量对结果的同时影响采用结构方程模型进行估计。抑郁和NYHA心功能分级独立预测HRQoL的物理领域。相比之下，心理域预测抑郁症，但不是由NYHA functionalclass.Conclusions：我们的研究结果表明，共病抑郁症有一个独立的影响后，控制心力衰竭症状的严重程度，慢性心力衰竭患者的身体和心理HRQoL，而心力衰竭的严重程度只影响身体HRQoL。因此，共病抑郁症的评估可能有助于解释降低HRQoL心力衰竭患者。研究似乎有必要评估抑郁的改善是否可以提高慢性心力衰竭患者的HRQoL。（J Cardiac Fail 2009：15：286-292）
Background: To examine whether depression and heart failure severity are independent predictors of both the physical and psychologic domains of health-related quality of life (HRQoL) in patients with chronic heart failure.Methods and Results: A sample of 206 outpatients with chronic heart failure (mean age 64 years, 69% male) was evaluated. Depression was measured with the Patient Health Questionnaire and disease-specific HRQoL with the Kansas City Cardiomyopathy Questionnaire. Heart failure severity was assessed with physician ratings of the New York Heart Association (NYHA) functional class. The simultaneous effects of predictor variables on outcomes were estimated using structural equation modeling. Both depression and NYHA functional class independently predicted the physical domain of HRQoL. By contrast, the psychologic domain was only predicted by depression, but not by NYHA functional class.Conclusions: Our results suggest that comorbid depression has an independent impact on both physical and psychologic HRQoL in patients with chronic heart failure after controlling for the severity of heart failure symptoms, while heart failure severity only impacts physical HRQoL. Thus, assessment of comorbid depression may help interpreting reduced HRQoL in heart failure patients. Research seems warranted evaluating whether the amelioration of depression may enhance patients' HRQoL in chronic heart failure. (J Cardiac Fail 2009:15:286-292)