Self-care and health-related quality of life in chronic heart failure: A longitudinal analysis

• Published in: European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology Vol. 16; no. 7; pp. 605 - 613
• Main Authors: Kessing, Dionne, Denollet, Johan, Widdershoven, Jos, Kupper, Nina
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.10.2017
• Subjects: Adult; Aged; Aged, 80 and over; Attitude to Health; Chronic Disease - psychology; Female; Heart Failure - psychology; Humans; Longitudinal Studies; Male; Middle Aged; Quality of Life - psychology; Self Care - psychology; Stress, Psychological; Surveys and Questionnaires; Type D Personality; heart failure; stress; psychological; Anxiety; depression; quality of life; Type D personality; self-care
• ISSN: 1474-5151; 1873-1953
• DOI: 10.1177/1474515117702021

Background: Self-care is assumed to benefit health outcomes in patients with chronic heart failure (HF), but the evidence is conflicting for health-related quality of life (HRQOL). The aim of this study was to examine the association of (changes in) self-care with HRQOL while adjusting for psychological distress. Methods: In total, 459 patients (mean age = 66.1 ± 10.5 years, 73% male) with chronic HF completed questionnaires at baseline and at 6, 12 and 18 months of follow-up. Self-care and HF-specific HRQOL were quantified with the European Heart Failure Self-care Behaviour scale and the Minnesota Living with Heart Failure Questionnaire. Results: Using general linear models, multivariable between-subject (estimate = –0.14, p = 0.005) and no within-subject effects of self-care were found for better HRQOL over time. Associations between self-care and HRQOL were fully explained by depression (estimate = 1.77, p < 0.001). Anxiety (estimate = 4.49, p < 0.001) and Type D personality (estimate = 13.3, p < 0.001) were associated with poor HRQOL, but only partially accounted for the relationship between self-care and emotional HRQOL. Conclusions: Self-care was prospectively associated with better disease-specific HRQOL in patients with HF, which was fully accounted for by depression, and partially accounted for by anxiety and Type D personality. Changes in self-care within a person did not affect HRQOL. Psychological distress should be considered in future efforts to address self-care and HRQOL.