Pain and Quality of Life in Hospitalized Patients with Heart Failure

Abstract

The pain experience of patients with heart failure (HF) and its impact on their quality of life (QOL) has not been described in sufficient detail. This study sampled patients hospitalized with HF to describe the prevalence and severity of bodily pain; evaluate differences in bodily pain related to selected demographic and disease-specific characteristics; and evaluate the effect of selected demographic, disease-specific characteristics, bodily pain, and mental health on QOL. Two items from the Medical Outcomes Study--Short Form (SF-36) were used to measure pain, and one subscale of the SF-36 was used to evaluate mental health. The Minnesota Living With Heart Failure Questionnaire was used to measure QOL. Patients with HF (n=93) had a mean age of 75 years, were predominantly male (65%), and lived alone (47.3%). Lung diseases and diabetes were the most common comorbidities; 58% were categorized as New York Heart Association (NYHA) Class III, whereas 58% of the sample was diagnosed with HF in the past four years. Of note, 85% of the patients reported pain and 42.5% said that it was in the severe or very severe range. No demographic variables were associated with pain, whereas a higher number of chronic conditions were associated with pain. SF-36 mental health and pain scores, as well as NYHA class, explained 34.1% of the variance in QOL in patients with HF. These data suggest that pain is highly prevalent and has a significant impact on the QOL of patients with HF. However, additional research is warranted to determine the specific causes and characteristics of pain in these patients.

Pain and quality of life with chronic obstructive pulmonary disease

“…For example, patients who have experienced heart failure reported pain to have a significant impact on their QOL. 20 Moreover, patients with COPD and lung cancer reported that chest pain correlated with the QOL domain. 56 Another example of how QOL is affected by pain is shown in a study by Smith et al 57 In a chronic pain group consisting of patients with neuropathic pain, the pain interference score was related to poor health and more disability than in other chronic pain groups.…”

“…18 Traditionally, pain is understood as a biopsychosocial phenomenon, calling for the investigation of the burden of pain on psychosocial variables. 19 The experience of pain is reported to affect both disease-specific QOL in patients with heart failure 20 and global QOL in patients with burn injuries. 21 Although disease-specific QOL is often explained by the presence of symptoms, global QOL is frequently conceptualized as satisfaction with overall life domains and happiness in life.…”

Utilizing Home Healthcare Electronic Health Records for Telehomecare Patients With Heart Failure

“…24,25 An alternative explanation for this finding is that when family members see a loved one in pain, they advocate for care that might involve rehospitalization. Finally, it also may be that more supportive therapies, such as physical therapy and occupational therapy, are indicated for these patients to address their pain, because the decision tree highlights the importance of the number of anticipated therapy visits among patients with severe pain.…”

Understanding Palliative Care on the Heart Failure Care Team: An Innovative Research Methodology

“…Interview and survey studies with patients with advanced HF find that they have physical, psychological, social, spiritual, and informational needs. [28][29][30][31][32][33] These needs are similar to those of patients with advanced cancer; 34 however, patients with HF understand less about their illness, have fewer choices regarding end-of-life care, and have more limited access to palliative care. 35,36 Patients may desire communication that they do not receive: one study found that not one of 20 patients had discussed disease progression or advanced care planning with staff members.…”