Jinbo Fang
Sichuan University, China
Title: Influencing factors of quality of life in chronic heart failure patients with cardiac resynchronization therapy
Biography
Biography: Jinbo Fang
Abstract
Background: The quality of life in heart failure patients could be impaired. Cardiac resynchronization therapy may improve quality of life in heart failure patients. However, there are still lack of empirical studies to exam the quality of life and the influencing factors in patients with cardiac resynchronization therapy. Objectives: To describe the quality of life and identify its influencing factors in chronic heart failure patients with cardiac resynchronization therapy. Methods: This cross-sectional study recruited 141 chronic heart failure patients with cardiac resynchronization therapy by convenient sampling. Instruments used in present study were Morisky Medication Adherence Scale, Charlson's Weighted Index of Comorbidities (WIC), Minnesota Living With Heart Failure Questionnaire (MLHFQ), Social Support Rating Scale (SSRS), Cardiac Depression Scale(CDS). Statistical software SPSS 20.0 are used for statistical analysis. Results: The mean overall score of MLHFQ was 30.89±12.11, and the mean score of subscales were 13.36±4.91 on physical domain and 7.43±2.86 on emotional domain. Male got higher scores than female on overall score and physical domain score (p<0.01). Patients aged lower than 65 got higher scores than those aged higher than 75 (p<0.01). Patients of whose family average monthly incomes less than 1000 Yuan got higher scores on physical domain(p<0.05). Patients without spouses got higher scores than those with spouses on emotional domain (p<0.05).Patients with pre-operation WIC scores more than 4 had higher scores than those with pre-operation WIC scores less than 3 overall (p<0.05). Pre-operation NYHA class IV patients get higher scores than Pre-operation NYHA class I-III patients overall and on physical domain and emotional domain(p<0.05). Patients with length of post-operation shorter than 3 months get higher scores than patients with length of post-operation longer than 3 months overall(p<0.05). Patients exercising regularly get lower scores than those without regular exercise overall and physical domain and emotional domain (p<0.05). The higher scores on subjective support, objective support, use of support and total level of social support related with lower scores on MLHFQ overall and physical domain and emotional domain(p<0.05). The higher scores on CDS related with higher scores on MLHFQ overall and physical domain and emotional domain (p<0.05). Multiple regression showed that: (i)for MLHFQ overall scores, influential factors were pre-operation NYHA class (β=0.262, p=0.001), scores on subjective support (β=0.239,p=0.002), gender (β=0.200,p=0.008), exercise (β=-0.207,p=0.006), scores on CDS (β=0.179, p=0.018). (ii) for scores on physical domain, influential factors were pre-operation NYHA class (β=0.251,p=0.001),scores on objective support (β=0.-0.209, p=0.006),exercise (β=-0.255,p=0.001),scores on use of support (β=-0.183, p=0.015),gender (β=0.177,p=0.019). (iii) for scores on physical domain, influential factors were scores on subjective support (β=-0.309,p=0.000), exercise (β=-0.22,p=0.004),scores on CDS (β=0.210, p=0.006), scores on WIC (β=0.165,p=0.030). Conclusion: Quality of life in patients with chronic heart failure could be improved by cardiac resynchronization therapy. Gender, age, income, material status, exercise, comorbidity, pre-operation NYHA class level, length of post-operation, social support and depression were influencing factors on quality of life in chronic heart failure patients with cardiac resynchronization therapy.