Relationship of symptom stress, care needs, social support, and meaning in life to quality of life in patients with heart failure from the acute to chronic stages: a longitudinal study

Abstract

Background Patients with heart failure (HF) experience continuous changes in symptom distress, care needs, social support, and meaning in life from acute decompensation to chronic phases. The longitudinal relationship between these four factors and quality of life (QOL) was not fully explored. Aims To simultaneously investigate the relationship between all factors and QOL from hospitalization to 6 months after discharge, and the impact of the changes in these factors on QOL at different time points. Methods A longitudinal design with panel research (4 time points) was used. From January 2017 to December 2019, patients hospitalized due to acute decompensated HF were consecutively enrolled and followed up for 6 months. Patients were interviewed with questionnaires assessing symptom distress, care needs, social support, meaning in life and QOL at hospitalization and 1, 3 and 6 months after discharge. Results A total of 184 patients completed 6 months of follow-up. From baseline to 6 months, QOL continuously improved along with decreases in symptoms and care needs, but increases in social support and meaning in life. Better QOL was associated with younger age, higher education level, economic independence, less symptom distress and care needs, and stronger meaning in life (p < 0.05). Compared with hospitalization, decreases in care needs and increases in meaning in life at 1, 3 and 6 months were associated with an increase in physical QOL (p < 0.01). The decrease in care needs and increase in meaning in life at 3 months were associated with an increase in mental QOL (p < 0.05). The increase in social support at 6 months was associated with increases in both physical and mental QOL (p < 0.01). Changes in symptom distress were not correlated with changes in QOL from baseline to all time points. In the multivariable analysis, these findings were independent of age, educational level and economic status. Conclusions Although symptom distress is associated with QOL after acute decompensated HF, QOL cannot be improved only by improvement in symptoms. With differential duration of improvement in each factor, the integration of alleviation in care needs and strengthening in social support and meaning in life might provide additional benefits in QOL.

The relationship between meaning of life, perceived social support, spiritual well-being and pain catastrophizing with quality of life in migraine patients: the mediating role of pain self-efficacy

“…In examining the first hypothesis of the study, the findings showed that the meaning of life has a direct significant relationship with quality of life (B = 0.11). Also, the meaning of life is indirectly significantly related to quality of life through mediation of pain self-efficacy (B = 0.015), results of the present study are consistent with findings of Majernikova and Obrocnikova [ 17 ]; Park et al [ 46 ], Barsaei et al [ 47 ]; Liu et al [ 48 ]. In explaining these findings, it can be stated that the search for meaning is a stressful process which high levels of meaning search, will lead to less adaptation, while high levels of meaning presence will lead to more adaptation and life satisfaction symptoms [ 81 ].…”

“…In such conditions, self-efficacy of pain as a protective factor, creates the belief that despite the presence of pain, it can function optimally [ 45 , 82 ]. Low self-efficacy leads to failure and a sense of lack of control over life events, and people believe that any attempt to find meaning is futile, while patients with high self-efficacy, see illness as a challenge rather than a threat [ 48 ]. For overcome to this challenge, by confidence in their abilities and changing the lens through which they view their life events, they try to reconstruct the meaning of their lives, that ultimately improves their quality of life in different dimensions [ 81 ].…”

“…The results of recent studies such as Majernikova and Obrocnikova [ 17 ] in cancer patients; Park et al[ 46 ], Barsaei et al [ 47 ], and Liu et al [ 48 ] in patients with heart failure; showed a significant relationship between meaning of life and quality of life. Findings of DeMaria et al [ 49 ] in patients with multiple chronic diseases; Costa et al [ 25 ], and Kever et al [ 21 ] in patients with multiple sclerosis; Ren et al [ 50 ] in patients with chronic wounds; Qi et al [ 51 ] in patients with type 2 diabetes; Aydın, and Demir [ 22 ], and Dun et al [ 52 ] in cancer patients; indicate that there is a positive and significant correlation between social support and quality of life.…”

Psychometric Evidence for the Lipp’ Adult Stress Symptoms Inventory

“…In addition, current evidence indicates that people who have had heart problems may experience a high level of anxiety and stress (Liu et al, 2021). In this sense, the low discrimination of having had a heart attack in the last month may suggest that heart attack is a condition with many outcomes and not just stress, as well as that the characteristics of the group surveyed are distinct from the clinical groups that often make up samples in epidemiological studies of risk factors (Kaur & Singh, 2016;Ramos et al, 2022).…”

Exploring the Meaning in Life and the Influencing Factors among Patients Undergoing Hemodialysis in Macau

“…However, most of the studies focused on the impacts on QoL of the patients ( Dąbrowska-Bender et al., 2018 ; Gomes Neto et al, 2018 ; Joshi et al, 2017 ). Some of the studies explored the relationships between the patients’ QoL and their levels of ML ( Hajibabaei et al, 2020 ; Liu et al., 2021 ). Despite the confirmed relationships between ML and QoL of patients with chronic conditions, few studies have exclusively examined the ML status of the patients with ESKD, leaving a knowledge gap for future research exploration.…”