Changes in Heart Failure Symptoms are Associated With Changes in Health-related Quality of Life Over 12 Months in Patients With Heart Failure
Changes in Heart Failure Symptoms are Associated With Changes in Health-related Quality of Life Over 12 Months in Patients With Heart Failure
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DOI：
10.1097/jcn.0000000000000493
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发表时间：
2018-09-01
影响因子：
2
通讯作者：
Ounpraseuth, Songthip
中科院分区：
文献类型：
--
作者：
Heo, Seongkum;Moser, Debra K.;Ounpraseuth, Songthip
目的：心力衰竭（HF）患者的健康相关生活质量（HRQOL）明显较差。HRQOL改善5分与住院率和死亡率降低相关。心力衰竭症状与HRQOL较差相关，但人们对心力衰竭症状的变化是否会导致HRQOL随时间的变化知之甚少。因此，我们研究了12个月期间HF症状变化与HRQOL总体、身体和情感方面变化的相关性，控制了典型的协变量。研究方法：在基线和12个月随访时，收集了94例HF患者（平均年龄58岁; 58.5%为女性）的HF症状和HRQOL（明尼苏达生活性心力衰竭问卷）数据。在基线时收集心理社会因素（抑郁症状、感知控制和社会支持）、行为因素（药物依从性和钠摄入量）、社会人口统计学和临床因素（年龄、合并症和体重指数）以及身体因素（功能状态）。采用多因素分析和Logistic回归分析。结果如下：在完整模型中，HF症状的变化与12个月内总HRQOL（P <.001）以及HRQOL的身体（P < .001）和情感（P < .001）方面的变化相关，控制了所有因素。HF症状的变化与HRQOL至少改善5分的可能性显著相关（P = 0.001），控制协变量。结论：HF症状的改善与12个月内HRQOL的改善相关。因此，针对HF症状改善的干预措施的开发和实施可能会改善HRQOL。
Purpose: Patients with heart failure (HF) have notably poor health-related quality of life (HRQOL). A 5-point improvement in HRQOL is associated with reduction in hospitalization and mortality rates. Heart failure symptoms are associated with poor HRQOL, but little is known about whether changes in HF symptoms lead to changes in HRQOL over time. Therefore, we examined the association of changes in HF symptoms with changes in overall, physical, and emotional aspects of HRQOL over a 12-month period, controlling for typical covariates. Methods: Data on HF symptoms and HRQOL (Minnesota Living Heart Failure questionnaire) were collected from 94 patients with HF (mean age, 58 years; 58.5% female) at baseline and 12-month follow-up. Psychosocial factors (depressive symptoms, perceived control, and social support), behavioral factors (medication adherence and sodium intake), sociodemographic and clinical factors (age, comorbidities, and body mass index), and a physical factor (functional status) were collected at baseline. Multiple and logistic regression analyses were used to analyze the data. Results: In complete models, changes in HF symptoms were associated with changes in the total HRQOL (P < .001) and the physical (P < .001) and emotional (P < .001) aspects of HRQOL over 12 months, controlling for all the factors. Changes in HF symptoms were significantly associated with the likelihood of at least a 5-point improvement in HRQOL (P = .001), controlling for covariates. Conclusions: Improvement in HF symptoms was associated with improvement in HRQOL over 12 months. Thus, development and delivery of interventions that target improvement in HF symptoms may improve HRQOL.