Dose-dependent relationship of physical and depressive symptoms with health-related quality of life in patients with heart failure

Abstract

Background Patients with heart failure (HF) have poor health-related quality of life (HRQOL). The vast majority of patients have physical symptoms, and about 30 to 40% have depressive symptoms. The combined effects of physical and depressive symptoms on HRQOL have not been examined fully in HF. Purposes To examine the combined effects of physical and depressive symptoms on HRQOL using repeated measures, controlling for covariates (i.e., age, education level, New York Heart Association [NYHA] functional class, financial status, and health perception). Methods Patients (N = 224, 62 ±12 years old, 67% male, 38% NYHA functional class III/IV) provided data on physical (Symptom Status Questionnaire) and depressive symptoms (Beck Depression Inventory II) at baseline and HRQOL (Minnesota Living with Heart Failure Questionnaire) at baseline and 12 months. Patients were divided into three groups based on presence of physical and depressive symptoms: a) no symptom group, b) one symptom group (dyspnea or fatigue), and c) two symptoms group (physical and depressive symptoms). Repeated measures ANOVA was used to analyze the data. Results The least squares mean scores of baseline and 12-month HRQOL differed significantly in the three groups after controlling for the covariates (26.4 vs. 36.6 vs. 53.1, respectively, all pairwise p values < .001). There was no time-by-group interaction or time main effect. Conclusion Physical and depressive symptoms have a dose-response relationship with HRQOL. Further research is needed to develop and deliver effective interventions to improve physical and depressive symptoms and to determine if improvement in physical and depressive symptoms results in improvement in HRQOL.

Bahraini men living with heart failure: A phenomenological study

“…[12,26] In this study the men who were in better physical condition and able to engage in paid employment were less anxious and reported a better quality of life. [5] In this study, sleep dissatisfaction was a significant finding. Satisfaction with sleep is a matter of personal expression; most of the men expressed dissatisfaction with their quality of sleep.…”

“…[2,5,6,26,27] The constant feeling of tiredness and exhaustion contributed to a low quality of life, all of which led them to seek medical care. [5] The sudden onset of symptoms, and the subsequent changes that occurred in the men's life was shocking to them, and they never imagined that they would have this condition that altered their physical fitness.…”

“…[3] Studies have indicated that for HF patients' physical and mental wellness formed the basis of quality of life and were significantly linked to the prognosis and outcomes of HF. [4,5] Physical symptoms resulted in a number of limitations affecting the patient's daily activities. For example, difficulties in climbing the stairs, doing household chores, carrying items, expressing sexuality and other activities of daily living were restricted.…”

Study of Fatigue and Associated Factors in Patients with Chronic Heart Failure

“…Samples of the study were selected by cardiologist's confirmation; they had previous diagnosis of heart failure at least for one year and they were selected after doing echo with ejection fraction (EF) of 20% -40% (treatment with heart drugs and not having recognized diseases; mental disorders, epilepsy, multiple sclerosis, stroke, hyperthyroidism and hypothyroidism, rheumatoid arthritis, different types of inflammatory diseases and cancer, kidney and adrenal insufficiency). Data collection was done in a single stage through using a questionnaire involving; 1. demographic data and questions in regards to duration, number of drugs, frequent physician visits, and regular drug use, and 2. the Pittsburgh sleep quality index, which is a standard questionnaire (17). Questions of seven categories assessed subjective sleep quality, delay in falling asleep, sleep duration, efficiency and effectiveness of sleep and inappropriate performance and disorders during the day.…”

“…In the study of Servaes et al (12), a relationship was observed between anxiety, depression and fatigue, also in the study of Beyrami et al (13), anxiety was determined as a significant factor of psychological fatigue and depression. Also in many other studies, depression (2,(14)(15)(16)(17)(18), stress (19) and anxiety (13,19,20) were reported along with fatigue. Other influential factors in fatigue include low hemoglobin (21)(22)(23)(24)(25) and sleep disorders (2,25,26).…”