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Anxiety, Depression, and Functional Status Are the Best Predictors of Health Status Patients With Heart Failure

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Although mortality related to heart failure HF is high, the number of patients living with HF increases annually. Therefore, health status is an increasingly important concept in the management of HF. In fact, most symptomatic patients are more concerned about their everyday health status than the length of their life. Yet, most investigators conduct intervention studies that are designed to reduce mortality. As a result, health status is poorly understood for patients with HF. Thus, we conducted this study to identify predictors of health status. Methods In this correlational study, we interviewed 87 patients age 73 -11 years 48 female ejection fraction EF 38 -15 New York Heart Association NYHA class IIIIV 53 immediately prior to discharge from a hospitalization for HF. Health status was conceptualized as health-related quality of life HRQOL measured using the Minnesota Living with Heart Failure Questionnaire, actual physical activity level measured over 24 hours using the Mini Mitter actigraph, and level of symptom burden measured using the Dyspnea-Fatigue Index. Hierarchical multiple regression techniques were used to deterrnine sociodemographic sex, age, living alone, clinical comorbidities, NYHA class, EF, health perception, and emotional anxiety, depression, and hostility measured using the Brief Symptom Inventory variables associated with health status. Results The model for each indicator of health status accounted for 37, 52, and 17 of the variance in HRQOL, symptom burden, and physical activity level, respectively. Variables independently associated with each indicator of health status are shown in the table. Based on the standardized beta coefficients, the three strongest predictors of health status were anxiety, NYHA class, and depression. Conclusions Although emotional variables are not routinely assessed clinically, clearly they have a major impact on health status.

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  • Anatomy and Physiology
  • Medicine and Medical Research

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