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. 2017 Oct;16(7):605-613.
doi: 10.1177/1474515117702021. Epub 2017 Mar 23.

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

Dionne Kessing  1 , Johan Denollet  1 , Jos Widdershoven  1   2 , Nina Kupper  1
Affiliations

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

Dionne Kessing et al. Eur J Cardiovasc Nurs. 2017 Oct.

Abstract

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.

Keywords: Anxiety; Type D personality; depression; heart failure; psychological; quality of life; self-care; stress.

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Conflict of interest statement

Conflict of interest: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Health-related quality of life total, emotional and physical component scores over time and stratified by self-care categories. Higher MLWHF scores denote worse health-related quality of life. Self-care groups were based on the median split of the longitudinal person-mean. MLWHF: Minnesota Living with Heart Failure.
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