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American Journal of Critical Care. 2008;17: 124-132
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Predictors and Effect of Physical Symptom Status on Health-Related Quality of Life in Patients With Heart Failure

By Seongkum Heo, RN, PhD, Lynn V. Doering, RN, DNSc, Jeanne Widener, RN, MSN and Debra K. Moser, RN, DNSc. Seongkum Heois an assistant professor at the Indiana University School of Nursing in Indianapolis. Debra K. Moseris a professor and holds the Gill Endowed Chair of Nursing at the University of Kentucky College of Nursing in Lexington. Lynn V. Doeringis an associate professor and section chair in acute care at the University of California, Los Angeles, School of Nursing. Jeanne Wideneris a doctoral student at Ohio State University in Columbus.

Corresponding author: Seongkum Heo, Indiana University School of Nursing, 1111 Middle Dr, NU426, Indianapolis, IN 46202-5107 (e-mail: heo2{at}iupui.edu).

Background Physical symptoms are common and distressing problems for patients with heart failure and may be the strongest predictor of health-related quality of life. Identification of variables predictive of physical symptom status is needed to develop effective interventions to improve health-related quality of life.

Methods A total of 84 patients discharged after being hospitalized for exacerbation of heart failure were followed up for 3 months. The Minnesota Living With Heart Failure Questionnaire and the Dyspnea-Fatigue Index were used to assess health-related quality of life and physical symptom status, respectively. Relationships of health-related quality of life and physical symptom status to baseline demographic, behavioral, biophysiological, and psychological variables were examined with bivariate correlations and stepwise multiple regression analyses.

Results Patients with better physical symptom status and those who worked, were older, and were less anxious at baseline reported better health-related quality of life (F=12.4, P<.001); physical symptom status was the strongest predictor. Patients who had less depression, worked, had higher perceived control, and were younger at baseline reported better physical symptom status (F=14.4, P<.001); depression was the strongest predictor.

Conclusions Physical symptom status is the most important predictor of health-related quality of life, and baseline depression and perceived control are the best predictors of physical symptom status. Interventions targeted to improve psychological status may improve physical symptom status and thereby improve health-related quality of life.




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