Issues in cardiovascular nursingA comparison of health-related quality of life between older adults with heart failure and healthy older adults
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)
- et al.
Self-care abilities of patients with heart failure
Heart Lung
(2001) - et al.
Cardiac failure: symptoms and functional status
J Psychosom Res
(1991) - et al.
The expanding national burden of heart failure in the United States: the influence of heart failure in women
Am Heart J
(2004) - et al.
Baseline quality of life as a predictor of mortality and hospitalization in 5,025 patients with congestive heart failure. SOLVD Investigations. Studies of Left Ventricular Dysfunction Investigators
Am J Cardiol
(1996) - et al.
Incidence, clinical and etiologic features, and outcomes of advanced chronic heart failure: the EPICAL StudyEpidemiologie de l’Insuffisance Cardiaque Avancee en Lorraine
J Am Coll Cardiol
(1999) - et al.
Epidemiology of heart failure
Am Heart J
(1991) - et al.
Testing a published model of health-related quality of life in heart failure
J Card Fail
(2005) - et al.
Assessment of patient outcome with the Minnesota Living with Heart Failure questionnaire: reliability and validity during a randomized, double-blind, placebo-controlled trial of pimobendanPimobendan Multicenter Research Group
Am Heart J
(1992) - et al.
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) - et al.
A brief self-administered questionnaire to determine functional capacity (the Duke Activity Status Index)
Am J Cardiol
(1989)
Changes in dyspnea-fatigue ratings as indicators of quality of life in the treatment of congestive heart failure
Am J Cardiol
The Memorial Symptom Assessment Scale: an instrument for the evaluation of symptom prevalence, characteristics and distress
Eur J Cancer
Health-related quality of life and sense of coherence among elderly patients with severe chronic heart failure in comparison with healthy controls
Heart Lung
A health perception score predicts cardiac events in patients with heart failure: results from the IMPRESS trial
J Card Fail
Depressive symptoms and risk of functional decline and death in patients with heart failure
J Am Coll Cardiol
Marital status, quality of life, and clinical outcome in patients with heart failure
Heart Lung
Preferences for quality of life or survival expressed by patients with heart failure
J Heart Lung Transplant
Impact of a home-based walking and resistance training program on quality of life in patients with heart failure
Am J Cardiol
Nonpharmacologic therapy improves functional and emotional status in congestive heart failure
Chest
Heart disease and stroke statistics—2005 update
Symptoms experienced in the last six months of life in patients with end-stage heart failure
Eur J Cardiovasc Nurs
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