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      Health-related quality of life determinants in outpatients with heart failure Translated title: Determinantes de la calidad de vida relacionada a la salud en pacientes atendidos en ambulatorios con insuficiencia cardíaca Translated title: Determinantes da qualidade de vida relacionada à saúde em pacientes ambulatoriais com insuficiência cardíaca

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          Abstract

          This descriptive and exploratory study analyzed variables associated with health-related quality of life among 130 outpatients. Health-related quality of life was measured through the Minnesota Living with Heart Failure Questionnaire. Significant associations were found between patients’ health-related quality of life and their age (r=-0.177; p=0.044), vitality (r=-0.625; p=<0.001) as well as mental health (r=-0.672; p=<0.001), which are both SF-36 domains. The linear regression showed that heart failure symptom severity, vitality and mental health explained 54% of HRQOL measurement variation. To control symptoms and preserve good mental well-being are important to maintain health-related quality of life and to deliver effective heart failure care.

          Translated abstract

          Trata-se de estudo descritivo e exploratório que analisou as variáveis associadas à qualidade de vida relacionada à saúde (QVRS), de 130 pacientes com insuficiência cardíaca, em seguimento ambulatorial. A QVRS foi avaliada pelo Minnesota Living with Heart Failure e realizada análise de regressão linear. A média da QVRS foi de 34,9 (dp=24,8; intervalo de 0 a 99). Foram encontradas associações significantes entre a medida da QVRS e idade (r=-0,177; p=0,044), vitalidade (r=-0,625; p=<0,001) e saúde mental (r=-0,672; p=<0,001), domínios do SF-36. A regressão linear mostrou que a gravidade dos sintomas da insuficiência cardíaca, e dois domínios do SF-36, vitalidade e saúde mental, explicaram 54% da variação da medida da QVRS. Controlar os sintomas e manter bem-estar mental é essencial para a manutenção da QVRS e são essenciais para o cuidado eficaz da insuficiência cardíaca.

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          Most cited references42

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          Heart disease and stroke statistics--2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee.

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            Impact of heart failure and left ventricular systolic dysfunction on quality of life: a cross-sectional study comparing common chronic cardiac and medical disorders and a representative adult population.

            Heart failure and left ventricular systolic dysfunction (LVSD) are increasingly common disorders, with outcomes worse than many cancers. Evidence-based therapies, such as ACE inhibitors and beta-blockers, improve prognosis and symptoms, and reduce healthcare expenditure. However, despite the high prevalence and malignant prognosis, few studies have reported the impact of heart failure and LVSD on overall quality of life and, more crucially, have not researched the elderly or those in the community. All patients attending the Echocardiographic Heart of England Screening (ECHOES) study of the prevalence of heart failure and LVSD in the community were assessed by clinical history and examination, electrocardiogram and echocardiography, and also completed the SF36 health status questionnaire. Quality of life in patients found to have heart failure, LVSD, and other cardiac and medical conditions are compared with the randomly selected general population sample. Data are generalisable to the UK. 6162 people in the community were screened in the ECHOES study, of whom 5961 (97%) completed the SF36. The health perceptions of 3850 people aged 45 years or older selected randomly from the population were compared with those of 426 patients diagnosed as having definite heart failure. Those with heart failure had significant impairment of all the measured aspects of physical and mental health, in addition to declines in physical functioning. Significantly worse impairment was found in those with more severe heart failure by NYHA class: indeed, NYHA functional class was closely correlated to SF36 score. Patients with asymptomatic left ventricular dysfunction and patients rendered asymptomatic by treatment had similar scores to the random population sample. Those with heart failure reported more severe physical impairment of quality of life than people giving a history of chronic lung disease or arthritis, with less impact on mental health than patients reporting depression. Patients with heart failure have statistically significant impairment of all aspects of quality of life, not simply physical functioning. The physical (role and functioning) health burden was significantly greater than that suffered in other serious common chronic disorders, whether cardiac or other systems. Optimising treatment to improve NYHA class appears to improve perceptions of quality of life for patients with heart failure. Given the dramatic decline in quality of life with heart failure, this end-point should be a much more important target for healthcare interventions, especially treatments such as ACE inhibitors and beta-blockers that are shown to improve quality of life. Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved
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              Impact of symptom prevalence and symptom burden on quality of life in patients with heart failure.

              Heart failure is an escalating health problem around the world. Despite significant scientific advances, heart failure patients experience multiple physical and psychological symptoms that can impact the quality of life. To determine the (1) symptom prevalence, severity, distress and symptom burden in patients with heart failure; (2) impact of age and gender on symptom prevalence, severity, distress and symptom burden; and (3) impact of symptom prevalence and symptom burden on health-related quality of life (HRQOL) in patients with heart failure. A convenience sample of 53 heart failure patients participated in this descriptive, cross-sectional design. Symptoms and HRQOL were measured using the Memorial Symptom Assessment Scale-Heart Failure and the Minnesota Living with Heart Failure Questionnaire. Patients experienced a mean of 15.1+/-8.0 symptoms. Shortness of breath and lack of energy were the most prevalent. Difficulty sleeping was the most burdensome symptom. Lower age, worse functional status, total symptom prevalence and total symptom burden predicted 67% of the variance in HRQOL. Patients with heart failure experience a high level of symptoms and symptom burden. Nurses should target interventions to decrease frequency, severity, distress and overall symptom burden and improve HRQOL.
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                Author and article information

                Journal
                rlae
                Revista Latino-Americana de Enfermagem
                Rev. Latino-Am. Enfermagem
                Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo (, SP, Brazil )
                0104-1169
                1518-8345
                June 2011
                : 19
                : 3
                : 451-457
                Affiliations
                [02] SP orgnameUniversidade de São Paulo orgdiv1Escola de Enfermagem de Ribeirão Preto Brazil vivi.pelegrino@ 123456bol.com.br
                [01] orgnameUniversidade de São Paulo orgdiv1Faculdade de Medicina de Ribeirão Preto orgdiv2Hospital das Clínicas Brasil
                [03] Edmonton orgnameUniversity of Alberta orgdiv1Faculty of Nursing Canada alex.clark@ 123456ualberta.ca
                Article
                S0104-11692011000300002 S0104-1169(11)01900302
                45009fe9-fb4c-4fe0-8fa6-bf59cabe3f43

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 15 March 2011
                : 05 May 2010
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 25, Pages: 7
                Product

                SciELO Brazil

                Categories
                Original Articles

                Heart Failure,Symptoms,Mental Health,Quality of Life,Sintomas,Saúde Mental,Qualidade de Vida,Insuficiência Cardíaca,Síntomas,Salud Mental,Calidad de Vida,Insuficiencia Cardíaca

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