Elsevier

Heart & Lung

Volume 36, Issue 1, January 2007, Pages 16-24
Heart & Lung

Issues in cardiovascular nursing
A comparison of health-related quality of life between older adults with heart failure and healthy older adults

https://doi.org/10.1016/j.hrtlng.2006.06.003Get rights and content

Background

Health-related quality of life (HRQOL) in older adults with heart failure may be affected by a variety of variables including aging. It is important to determine the unique impact of heart failure to more effectively improve HRQOL in this population.

Objective

The purpose of this study was to compare HRQOL and physical, psychologic, clinical, and sociodemographic status in older adults with and without heart failure.

Methods

The HRQOL of 90 older adults with heart failure and 116 healthy older adults was compared. The factors best associated with HRQOL in each group were determined using multiple regression model.

Results

HRQOL was substantially worse among older adults with heart failure than among healthy older adults. Older adults with heart failure had more severe physical and emotional symptoms, poorer functional status, and worse health perceptions. Physical symptom status was the strongest predictor of HRQOL in both groups. In addition, in older adults with heart failure, physical symptom status, age, and anxiety were related to HRQOL.

Conclusion

The poor HRQOL seen in patients with heart failure is not just a reflection of aging. Comprehensive interventions targeted toward the factors that specifically negatively impact HRQOL are essential in older adults with heart failure.

Section snippets

Conceptual framework

The conceptual framework for this study was Wilson and Cleary’s original HRQOL model.15, 16 On the basis of the Wilson and Cleary model we selected the following variables as potentially associated with HRQOL: health perception, functional status, symptom status, biologic/physiologic status, individual characteristics, and environmental characteristics (Fig 1).

Methods

In this study, baseline data on HRQOL from older adults with heart failure participating in a trial of heart failure disease management17 and from older adults without heart disease (referenced throughout as healthy older adults) were compared. In addition, to determine the best model of HRQOL in each sample, health perception, functional status, symptom status (physical symptom status and emotional symptom status—depression and anxiety), biologic/physiologic status (number of comorbidities),

Characteristics of sample

Ninety older adults with heart failure and 116 healthy older adults were included in this study. The mean ages of older adults with heart failure and healthy older adults were 75 ± 8 years and 74 ± 6 years, respectively (Table II). There were no differences between the two groups in age, marital status, or living arrangements. However, older adults with heart failure were slightly less educated and had more comorbidities than healthy older adults. There was a difference in gender ratio in both

Discussion

This study demonstrates that increasing age alone is not responsible for the worse HRQOL seen in older adults with heart failure. Even though both groups were of similar age, older adults with heart failure reported poorer HRQOL, worse health perceptions, inferior functional status, and more severe physical and emotional symptoms than did healthy older adults. Older adults with heart failure had a more negative perception of the impact of their physical and psychologic status on their daily

Conclusion

Compared with healthy older adults, older adults with heart failure demonstrated poorer physical and psychologic status, and their HRQOL reflected this. Older adults with heart failure had more severe physical and emotional symptoms, and poorer functional status, health perception, and HRQOL than did healthy older adults. Thus the negative HRQOL and other negative symptomology seen in patients with heart failure is not a reflection of aging. Despite marked differences in physical, psychologic,

References (42)

Cited by (92)

  • The effect of persistent anxiety and depressive symptoms on quality of life among patients with heart failure

    2021, Applied Nursing Research
    Citation Excerpt :

    Consequently, heart failure negatively affects not only the physical aspect but all of the patients' social, emotional, psychological, economic aspects as well as their quality of life (QoL) (Alaloul et al., 2017). Studies have shown that PwHF as well as having worse QoL than the general population, have worse QoL than other chronic disease patients (AbuRuz et al., 2016a; Chu et al., 2014; Comín-Colet et al., 2016; Demir & Unsar, 2011; Heo et al., 2007; Savarese & Lund, 2017; Wu et al., 2016). Quality of life is defined as “an individual's perception of their position in life in the context of the culture and value system in which they live, and in relation to their goals, expectations, standards and concerns” (Hayeah et al., 2017; Uchmanowicz & Gobbens, 2015).

  • Device-detected congestion is associated with worse patient-reported outcomes in heart failure

    2019, Heart and Lung
    Citation Excerpt :

    Currently, 6.5million Americans are diagnosed with HF and that number is projected to increase by 46% by 2030.1 In spite of recent improvements in medical management and technological advances in the treatment of HF, patients with HF continue to experience poor quality of life due to distressing symptoms such as dyspnea, fatigue, depression and anxiety,2–4 and HF remains the leading cause of hospital admission for older adults. Cardiopulmonary congestion resulting from fluid overload and elevated pressures in the heart is a common cause of symptoms and it is a primary reason for HF hospitalization.5–7

View all citing articles on Scopus
View full text