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Heart failure patients future expectations and their association with disease severity, quality of life, depressive symptoms and clinical outcomes
Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping. University of Calif Irvine, CA USA.ORCID iD: 0000-0002-4259-3671
University of Groningen, Netherlands.
Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Australian Catholic University, Australia.
2016 (English)In: International journal of clinical practice (Esher), ISSN 1368-5031, E-ISSN 1742-1241, Vol. 70, no 6, 469-476 p.Article in journal (Refereed) PublishedText
Abstract [en]

BackgroundAlthough treatment of heart failure (HF) patients has improved, prognosis still remains poor. Current HF Guidelines recommend communication about prognosis with all patients. Little is known about HF patients awareness of their shortened life expectancy. AimTo explore HF patients future expectations and to examine whether these expectations are associated with disease severity, quality of life, depressive symptoms and clinical outcomes. MethodPatients randomised to the intervention groups of the COACH study, who were at the end of HF hospitalisation, were asked about their future expectations. Patients were divided into three groups: patients expecting improvement/stabilisation, patients expecting deterioration and those not knowing what to expect. Depressive symptoms were measured by CES-D and quality of life with the Ladder of Life and RAND-36. ResultsSix hundred and seventy eight patients (age 70 12; 41% female patients; LVEF 33% +/- 15) participated in the study. Most patients (56%, N = 380) expected improvement or stabilisation, 8% (N = 55) expected deterioration and 21% (N = 144) did not know what to expect for the future. Patients who expected to deteriorate were significantly older, experienced a lower quality of life and more depressive symptoms compared with patients in the other two groups. They also had a higher mortality rate, both after 18 and 36 months, and had more HF admissions. No association with severity of the disease (NYHA-class, LVEF, BNP levels) was found. ConclusionMany hospitalised HF patients are not aware of their poor prognosis. Depressive symptoms, poor quality of life, increased mortality and rehospitalisation were related to expected deterioration. Improvement of communication about prognosis with HF patients is needed in the future.

Place, publisher, year, edition, pages
WILEY-BLACKWELL , 2016. Vol. 70, no 6, 469-476 p.
National Category
Family Medicine
Identifiers
URN: urn:nbn:se:liu:diva-129670DOI: 10.1111/ijcp.12802ISI: 000377199300007PubMedID: 27125731OAI: oai:DiVA.org:liu-129670DiVA: diva2:942288
Note

Funding Agencies|Netherlands Heart Foundation [2000Z003]

Available from: 2016-06-23 Created: 2016-06-23 Last updated: 2016-08-21

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The full text will be freely available from 2017-04-29 14:41
Available from 2017-04-29 14:41

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van der Wal, MartjeStrömberg, AnnaJaarsma, Tiny
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Division of Health, Activity and CareFaculty of Medicine and Health SciencesDivision of Nursing ScienceDepartment of Cardiology in Linköping
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International journal of clinical practice (Esher)
Family Medicine

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