Prediction of Heart Failure Symptoms and Health-Related Quality of Life at 12 Months From Baseline Modifiable Factors in Patients With Heart Failure
Prediction of Heart Failure Symptoms and Health-Related Quality of Life at 12 Months From Baseline Modifiable Factors in Patients With Heart Failure
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DOI：
10.1097/jcn.0000000000000642
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发表时间：
2020-03-01
影响因子：
2
通讯作者：
Turrise, Stephanie
中科院分区：
文献类型：
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作者：
Heo, Seongkum;Moser, Debra K.;Turrise, Stephanie
背景在心力衰竭(HF)患者中，良好的健康相关生活质量(HRQOL)与更长的生存期一样有价值，甚至更有价值。然而，HRQOL非常差，而且心力衰竭症状与HRQOL差有很强的相关性。本研究旨在探讨心力衰竭症状的心理、行为和生理预测因素，以及心力衰竭症状在抑郁症状和心力衰竭生活质量关系中的中介作用。数据包括基线时的样本特征、抑郁症状、知觉控制感、社会支持、纽约心脏协会(NYHA)功能分级、服药依从性、钠摄入量、自我护理管理和HF症状，以及12个月时的HF症状和HRQOL。结果基线抑郁症状(P<；.001)、服药依从性(P=.010)、钠摄入量(P=.032)和NYHA功能分级(P=.040)显著预测12个月的心衰症状，并控制协变量(F=7.363，R2=47%，P<；.001)。基线服药依从性(P=.001)、NYHA功能分级(P<；.001)和心力衰竭症状(P=.013)显著预测12个月的高危生活质量(F=10.701，R-2=59%，P<；.001)。基线心力衰竭症状完全中介基线抑郁症状与12个月HRQOL之间的关系。结论针对多维、可修改的预测因子，如自我护理、抑郁症状和NYHA功能分级，可以改善心力衰竭和HRQOL的症状。
BackgroundIn patients with heart failure (HF), good health-related quality of life (HRQOL) is as valuable as, or more valuable than, longer survival. However, HRQOL is remarkably poor, and HF symptoms are strongly associated with poor HRQOL. Yet, the multidimensional, modifiable predictors have been rarely examined.ObjectiveThe aim of this study was to examine the baseline psychosocial, behavioral, and physical predictors of HF symptoms and HRQOL at 12 months and the mediator effect of HF symptoms in the relationship between depressive symptoms and HRQOL.MethodsWe collected data from 94 patients with HF (mean +/- SD age, 58 +/- 14 years). Data included sample characteristics, depressive symptoms, perceived control, social support, New York Heart Association (NYHA) functional class, medication adherence, sodium intake, self-care management, and HF symptoms at baseline, as well as HF symptoms and HRQOL at 12 months. Multiple regression analyses were performed to address the purpose.ResultsBaseline depressive symptoms (P < .001), medication adherence (P = .010), sodium intake (P = .032), and NYHA functional class (P = .040) significantly predicted 12-month HF symptoms, controlling for covariates (F = 7.363, R-2 = 47%, P < .001). Baseline medication adherence (P = .001), NYHA functional class (P < .001), and HF symptoms (P = .013) significantly predicted 12-month HRQOL (F = 10.701, R-2 = 59%, P < .001). Baseline HF symptoms fully mediated the relationship between baseline depressive symptoms and 12-month HRQOL.ConclusionSymptoms of HF and HRQOL could be improved by targeting multidimensional, modifiable predictors, such as self-care, depressive symptoms, and NYHA functional class.