Background
Heart failure (HF) is a progressive clinical condition that results in substantial
impairment of quality of life (QOL). Helping patients maintain optimal QOL is essential.
QOL reflects patients' subjective perceptions about the impact of a clinical condition
and its treatment on daily life; however, definitions in the literature vary widely
and few reflect the patient's perspective.
Purpose
The study explored how patients with HF define and perceive QOL.
Methods
Qualitative data were obtained from 14 men and 6 women with HF (mean age 58 ± 10 years)
using semistructured open-ended interviews. The interviews were analyzed using content
analysis.
Results
Patients with HF defined QOL as their ability to 1) perform desired physical and social
activities to meet their and their family's needs; 2) maintain happiness; and 3) engage
in fulfilling relationships with others. Patients perceived a variety of factors as
positively or negatively affecting QOL: physical (symptoms and good or poor physical
status), psychologic (mood and positive or negative perspective), economic (financial
status), social (social support and ability for social activities), spiritual, and
behavioral (self-care). Patients perceived that HF had a serious impact on QOL, but
most evaluated their QOL as good nonetheless.
Conclusion
Patients' definition of QOL reflected not only the impact of HF on their daily life
but also their active pursuit of happiness. Patients' self-evaluation of QOL reflected
the negative impact of HF and patients' altered expectations of what constituted good
QOL.
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References
- Preferences for quality of life or survival expressed by patients with heart failure.J Heart Lung Transplant. 2001; 20: 1016-1024
- Health related quality of life in patients with congestive heart failure: Comparison with other chronic diseases and relation to functional variables.Heart. 2002; 87: 235-241
- Changes in health-related quality of life in older patients with acute myocardial infarction or congestive heart failure: a prospective study.J Am Geriatr Soc. 2001; 49: 1052-1058
- The MacNew heart disease health-related quality of life instrument: reference data for users.Qual Life Res. 2002; 11: 173-183
- Quality of life in women with heart failure, normative groups, and patients with other chronic conditions.Am J Crit Care. 2002; 11: 211-219
- Predictors of quality of life in patients with advanced heart failure awaiting transplantation.J Heart Lung Transplant. 1995; 14: 2-10
- Correlates of health-related quality of life in patients with heart failure.Heart Lung. 2002; 31: 85-93
- Quality of life in patients with advanced heart failure.J Heart Lung Transplant. 1992; 11: 273-279
- Symptoms experienced in the last six months of life in patients with end-stage heart failure.Eur J Cardiovasc Nurs. 2003; 2: 213-217
- Impact of symptom prevalence and symptom burden on quality of life in patients with heart failure.Eur J Cardiovasc Nurs. 2005; 4: 198-206
- Depressive symptoms and risk of functional decline and death in patients with heart failure.J Am Coll Cardiol. 2001; 38: 199-205
- Relationship between exertional symptoms and functional capacity in patients with heart failure.J Am Coll Cardiol. 1999; 33: 1943-1947
- Predictors of quality of life in women with heart failure.J Heart Lung Transplant. 2000; 19: 598-608
- Cardiac failure: symptoms and functional status.J Psychosom Res. 1991; 35: 399-407
- Living with advanced heart failure: a prospective, community based study of patients and their carers.Eur J Heart Fail. 2004; 6: 585-591
- Relationships between clinical assessments and patients' perceptions of the effects of heart failure on their quality of life.J Card Fail. 2006; 12: 87-92
- Self-rating of quality of life provides additional prognostic information in heart failure.Eur J Heart Fail. 2002; 4: 337-343
- Baseline quality of life as a predictor of mortality and hospitalization in 5,025 patients with congestive heart failure.Am J Cardiol. 1996; 78: 890-895
- Assessment of quality of life as observed from the baseline data of the Studies of Left Ventricular Dysfunction (SOLVD) trial quality-of-life substudy.Am J Cardiol. 1993; 71: 1069-1073
- The Minnesota Living With Heart Failure Questionnaire: Sensitivity to differences and responsiveness to intervention intensity in a clinical population.Nurs Res. 2002; 51: 209-218
- Correlates of health-related quality of life among lower-income, urban adults with congestive heart failure.Heart Lung. 2003; 32: 391-401
- Caregiving and care receiving among a technologically dependent heart failure population.ANS Adv Nurs Sci. 2000; 23: 82-97
- Relationship between psychological profile and cardiological variables in chronic heart failure.Eur Heart J. 1999; 20: 1579-1586
- Evaluation of 3 quality of life measurement tools in patients with chronic heart failure.Heart Lung. 2001; 30: 332-340
- Health perceptions of primary care patients and the influence on health care utilization.Med Care Mar. 1989; 27: S99-S109
- Distance between patients' subjective perceptions and objectively evaluated disease severity in chronic heart failure.Psychother Psychosom. 2003; 72: 166-170
- Gender differences in quality of life are minimal in patients with heart failure.J Card Fail. 2003; 9: 42-48
- Congestive heart failure patients' perceptions of quality of life: the integration of physical and psychosocial factors.Aging Ment Health. 2004; 8: 83-91
- Patient's view of heart failure: from the understanding to the quality of life.Eur J Cardiovasc Nurs. 2003; 2: 275-281
- Decompensated heart failure: symptoms, patterns of onset, and contributing factors.Am J Med. 2003; 114: 625-630
- Assessment of patient outcome with the Minnesota Living with Heart Failure questionnaire: reliability and validity during a randomized, double-blind, placebo-controlled trial of pimobendan.Am Heart J. 1992; 124: 1017-1025
- The MOS 36-item short-form health survey (SF-36).Med Care. 1992; 30: 473-483
- Gender differences in the effects of physical and emotional symptoms on health-related quality of life in patients with heart failure.Circulation. 2005; 111: E-59
- Dyspnea duration, distress, and intensity in emergency department visits for heart failure.Heart Lung. 2001; 30: 47-56
- Older adults' symptoms and their duration before hospitalization for heart failure.Heart Lung. 1997; 26: 169-176
- Symptoms in patients with heart failure are prognostic predictors: insights from COMET.J Card Fail. 2005; 11: 288-292
- Relationship of depression to increased risk of mortality and rehospitalization in patients with congestive heart failure.Arch Intern Med. 2001; 161: 1849-1856
- Depression in patients with heart failure.J Card Fail. 2005; 11: 30-35
- Relationship of physical symptoms and physical functioning to depression in patients with heart failure.Heart Lung. 2001; 30: 98-104
- The association between disease severity, functional status, depression and daily quality of life in congestive heart failure patients.Qual Life Res. 2004; 13: 63-72
- Effects of depression and anxiety on mortality and quality-of-life 4 months after myocardial infarction.J Psychosom Res. 2000; 49: 229-238
- Changes in dyspnea-fatigue ratings as indicators of quality of life in the treatment of congestive heart failure.Am J Cardiol. 1989; 64: 50-55
- The PHQ-9: validity of a brief depression severity measure.J Gen Intern Med. 2001; 16: 606-613
- Screening for depression in patients with coronary heart disease (data from the Heart and Soul Study).Am J Cardiol. 2005; 96: 1076-1081
- Comparison of Beck Depression Inventories-IA and -II in psychiatric outpatients.J Pers Assess. 1996; 67: 588-597
- Symptom status and quality-of-life outcomes of home-based disease management program for heart failure patients.Outcomes Manag. 2002; 6: 161-168
- A comprehensive management system for heart failure improves clinical outcomes and reduces medical resource utilization.Am J Cardiol. 1997; 79: 58-63
- Improved outcomes from a comprehensive management system for heart failure.Eur J Heart Fail. 2001; 3: 619-625
- Determinants of perceived health in patients with left ventricular dysfunction: a structural modeling analysis.Psychosom Med. 1997; 59: 193-200
- Socioeconomic status as an independent risk factor for hospital readmission for heart failure.Am J Cardiol. 2001; 87: 1367-1371
- More ‘malignant’ than cancer?.Eur J Heart Fail. 2001; 3: 315-322
- Self-forgiveness, spirituality, and psychological adjustment in women with breast cancer.J Behav Med. 2006; 29: 29-36
- Measuring spiritual well-being in people with cancer: the functional assessment of chronic illness therapy—Spiritual Well-being Scale (FACIT-Sp).Ann Behav Med. 2002; 24: 49-58
- Exploring the relationships among spiritual well-being, quality of life, and psychological adjustment in women with breast cancer.Psychooncology. 1999; 8: 429-438
- The impact of socio-cultural and clinical factors on health-related quality of life reports among Hispanic and African-American cancer patients.J Outcome Meas. 1999; 3: 200-215
- Active coping mediates the association between religion/spirituality and quality of life in ovarian cancer.Gynecol Oncol. 2006; 101: 102-107
- The role of spirituality in the psychological adjustment to cancer: a test of the transactional model of stress and coping.Int J Behav Med. 2004; 11: 48-55
- Spirituality in persons with heart failure.J Holist Nurs. 2002; 20 (quiz 26-30): 5-25
- Quality of life in older patients with systolic and diastolic heart failure.Eur J Heart Fail. 1999; 1: 151-160
- Predictors of quality of life in patients at one year after heart transplantation.J Heart Lung Transplant. 1999; 18: 202-210
- Factors contributing to rehospitalization of elderly patients with heart failure.J Cardiovasc Nurs. 1997; 11: 75-84
- Prognostic importance of emotional support for elderly patients hospitalized with heart failure.Circulation. 1998; 97: 958-964
- Correlates of psychological distress in elderly patients with congestive heart failure.J Psychosom Res. 2004; 57: 573-581
- Cognitive impairment in heart failure: issues of measurement and etiology.Am J Crit Care. 2002; 11: 520-528
- Management of heart failure in the elderly.Heart Fail Rev. 2002; 7: 89-97
- Executive summary: HFSA 2006 Comprehensive Heart Failure Practice Guideline.J Card Fail. 2006; 12: 10-38
- Management of heart failure.JAMA. 1994; 272: 1442-1446
- Characterization of the precipitants of hospitalization for heart failure decompensation.Am J Crit Care. 1998; 7: 168-174
- Social support and health-related quality of life in chronic heart failure patients.Qual Life Res. 2001; 10: 671-682
Article info
Publication history
Published online: September 22, 2008
Footnotes
Funded by an American Heart Association Postdoctoral Fellowship to Seongkum Heo and National Institutes of Health NINR R01 NR009280 to Terry Lennie.
Identification
Copyright
© 2009 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
