Introduction: Patients with heart failure (HF) report that good health-related quality of life (HRQOL) is more valuable than longer survival, and improvement in HRQOL after discharge has been associated with lower rates of hospitalization. However, HRQOL in patients with HF is remarkably poorer than that in patients with other chronic diseases. To improve HRQOL effectively, it is critical to examine comprehensive modifiable predictors. However, to our knowledge, this has not been examined in patients with HF.
Purpose: To examine baseline psychosocial, behavioral, and physical predictors of HRQOL at 12 months in patients with HF.
Methods: We collected data on HRQOL at 12 months using the Minnesota Living with Heart Failure Questionnaire and other data at baseline from 94 patients with HF (mean age 58 ± 14 years). We collected data on all psychosocial variables, one behavioral variable, and one physical variable using questionnaires: depressive symptoms (Patient Health Questionnaire), perceived control (Control Attitudes Scale-Revised), social support (Multidimensional Scale of Perceived Social Support), self-care management (Self-care management subscale of the Self-Care of Heart Failure Index), and HF symptoms (Symptom Status Questionnaire-HF). We assessed one physical factor (New York Heart Association [NYHA] functional class) using in-depth interview. We assessed two behavioral factors using objective measures: medication adherence (Micro-Electro-Mechanical Systems) and sodium intake (24-hour urine). Covariates were age and comorbidity. Multiple regression analysis was used to address the purpose.
Results: After controlling for covariates, among multidimensional psychosocial, behavioral, and physical variables, 3 modifiable factors (medication adherence [p = .001], HF symptoms [p = .011], and NYHA functional class [p < .001]) significantly predicted 12-month HRQOL (F = 11.853, R2 = .59, p < .001).
Conclusion: The findings of this study demonstrate multidimensional, modifiable predictors that interventions can target to improve HRQOL. Clinicians and researchers can target improvement in self-care, HF symptoms, and NYHA functional class to improve HRQOL, and, in turn, to reduce hospitalization rates.