January 15, 2015
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Patient HF acceptance linked to improved quality of life

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The degree to which patients accept their HF diagnosis may affect quality of life, new data suggest.

Researchers evaluated 100 adult patients (68 men; mean age, 63.2 years) with NYHA class II, III or IV HF from 2012 to 2013.

Patients responded to the Nottingham Health Profile (NHP) questionnaire and were rated on the Acceptance of Illness Scale. The NHP score assesses patients’ health status and its effect on daily functioning on a 0 to 38 scale across six domains: energy, pain, emotional reactions, sleep, social isolation and mobility, with higher scores indicating increased impairment in each domain. The five-item Acceptance of Illness Scale assesses responses to eight questions pertaining to a sense of difficulty and limitation due to illness, with scores ranging from 8 to 40 and higher scores indicating greater illness acceptance.

High acceptance levels (>29 points) were observed in 40 patients, moderate levels (19-29 points) in 36 patients and low levels (<18 points) in 24 patients.

Patients with low acceptance levels had significantly higher NHP scores for emotional reaction, energy, mobility, pain, sleep and social isolation, and the researchers observed inverse correlations between level of illness acceptance and each NHP domain (P<.001 for all).

Several sociodemographic factors, including age, sex, educational level and marital status, had a significant effect on NHP score. However, only illness acceptance was independently predictive of quality of life across all six domains on multivariable analysis (P<.001 for all). The researchers also noted that male sex was independently predictive of lower NHP scores for pain (P=.001), and divorce was associated with significantly increased social isolation scores (P<.001).

“Successful treatment depends, among other factors, on illness acceptance,” Monika Obieglo, a nurse in the department of clinical nursing at Wroclaw Medical University in Poland, said in a press release. “Identifying patients with chronic HF who do not accept their illness is vital to the effectiveness of treatment. Education programs are needed for patients and families to help them understand the nature of the illness, symptoms, treatment methods and how to take control of their health.”

Disclosure: The researchers report no relevant financial disclosures.