Background: Heart failure is an increasing global health problem which adversely affects all aspects of a patient's health-related quality of life (HRQOL). Purpose: The hypothesized causal model of HRQOL in Thai heart-failure patients was based on Wilson and Cleary's HRQOL conceptual model. We examined causal relationships among bio-physiological status, symptoms, functional status, general health perception (GHP), and HRQOL shown in the model, and added an additional item-social support. Methods: A stratified four-stage random sampling method was used to obtain 422 heartfailure patients 18 years of age and older who visited nine outpatient hospital clinics from five regions of Thailand including metropolitan Bangkok. In addition to the participants' personal medical records, research instruments consisted of a personal information questionnaire, the Enhancing Recovery in Coronary Heart Disease Social Support Instrument, Cardiac Symptom Survey, the New York Heart Association functional classification system, a 100-mm horizontal visual analogue scale of GHP, and the Minnesota Living with Heart Failure Questionnaire. Data were analyzed using SPSS and AMOS computer programs. Results: The model fit well with the empirical data (χ 2 =19.87, df=13, p=0.10, GFI=0.99, and RMSEA=0.04). Symptom status was the most influential factor affecting HRQOL by both direct and indirect effects through functional status and GHP. Social support was the least influential factor affecting HRQOL. Social support had a negative direct effect on HRQOL, but had a positive indirect effect on HRQOL through symptom status and GHP. Conclusions: HRQOL was affected by each variable proposed in our causal model of HRQOL in Thai heart-failure patients. Symptom status had the strongest effect on HRQOL.Clinical Relevance: A comprehensive symptom management and prevention program that includes the described health outcome measures could lead to improved HRQOL for Thai heart-failure patients, and perhaps others.
Purpose The purpose of this paper is to describe the quality of life (QOL) and to examine factors predicting the QOL among the demographic characteristics, injury severity, effect on work, pain intensity, disability point, coping and resilience factors, in Thai patients following multiple injuries. Design/methodology/approach A cross-sectional research design was used. A total of multiple 106 trauma patients were obtained by simple random sampling. The patients were between 18 and 59 years of age, and had visited an outpatient clinic at one of three randomly selected tertiary hospitals in Metropolitan Bangkok, Thailand. Dependent variable was QOL measured by Trauma Outcome Profile (TOP) questionnaire. Independent variables were demographic and illness-related factors collected from patients’ medical records, coping measured by the Jalowiec Coping Scale, pain measured by the Chronic Pain Grade questionnaire (CPGQ) and resilience measured by the Connor-Davidson Resilience Scale (CD-RISC-10). Data were analyzed using descriptive statistics and multiple regression analysis. Findings Except for satisfaction, the other nine dimensions of the QOL in patients following traumatic injuries were poor. Pain intensity was the most influential factor predicting the QOL, but the patient’s resilience, emotional coping and disability points were also able to predict the QOL. Originality/value The TOP, CPGQ and CD-RISC-10 were translated into Thai and used in the current study for the first time. The results of the study revealed that the pain intensity, and the patient’s resilience and coping influenced the QOL more than other factors, such as the demographic data and injury severity.
Background: Although acute coronary syndrome impacts patients’ health-related quality of life, a dearth of studies explore this issue in Indonesia. Thus, understanding factors associated with health-related quality of life among patients with acute coronary syndrome is a necessity. Objective: This study aimed to examine the relationships between age, pain, dyspnea, functional status, self-efficacy, social support, and health-related quality of life in patients with acute coronary syndrome in West Java, Indonesia. Methods: This study employed a descriptive correlational study involving 186 patients with acute coronary syndrome purposively selected in the outpatient clinics of the top referral public hospital. Data were collected in 2020 using validated instruments: Rose Questionnaire for Angina (RQA), Rose Dyspnea Scale (RDS), Seattle Angina Questionnaire (SAQ), General Self-efficacy Scale (GSE), ENRICHD Social Support Instrument (ESSI), and MacNew Health-Related Quality of Life. Data were analyzed using descriptive statistics and Spearman-rank correlation. Results: Overall, the health-related quality of life in patients with acute coronary syndrome was high (Mean = 4.97, SD = 0.92), including in its subscales: emotional (Mean = 4.94, SD = 0.88), physical (Mean = 5.07, SD = 1.12), and social (Mean = 5.05, SD = 1.55) subscales. Significant factors related to health-related quality of life were pain (r = 0.296, p <0.001), functional status (r = 0.601, p <0.001), dyspnea (r = -0.438, p<0.001), and self-efficacy (r = 0.299, p <0.001). Meanwhile, age and social support had no significant relationships with health-related quality of life (p = 0.270, p = 0.059). Interestingly, social support was significantly correlated with the emotional subscale of health-related quality of life (r = 0.156, p = 0.034). Conclusion: Functional status, pain, and self-efficacy were positively correlated with health-related quality of life, while dyspnea had a negative association. This finding serves as basic information for nurses and other healthcare professionals to consider the related factors identified in this study to improve nursing interventions in order to increase health-related quality of life among patients with acute coronary syndrome.
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