Assessment of health-related quality of life in patients with heart failure: a cross-sectional study in Saudi Arabia
Tóm tắt
As a precarious clinical condition and a public health problem, heart failure (HF) is associated with a significant burden of morbidity, mortality, and health care costs. As almost all of the published research has been conducted in Western countries, there is a need for culturally relevant studies in Saudi Arabia. This is the first study to investigate health-related quality of life (HRQoL) and its associated factors among Saudi patients with HF in the Qassim region.
A cross-sectional study was conducted at the only tertiary care hospital in the Qassim region of Saudi Arabia during the period from November 2020 to July 2021. The participants were interviewed face-to-face by trained interviewers using the standard validated 36-item Short-Form Health Survey (SF-36) questionnaire for HRQoL assessment. The data were analyzed using STATA version 16. The participants included 246 HF patients whose mean (SD) age was 56.7 (10.9) years. A majority of the respondents (80%, n = 197) were male, and 49% (n = 121) had an education level of less than secondary school. The median scores were high for the domains of social functioning (100 points) and bodily pain (75 points) and low for role-physical functioning (25 points). In general, the median scores for the physical and mental component summaries were 58.1 and 63.7, respectively. Patients with an education level less than secondary school were more likely to have a low physical component summary score (aOR 3.00, 95% CI 1.46–6.17), while female patients were more likely to have a low mental component summary score (aOR 2.67, 95% CI 1.38–5.16). Health-related quality of life was found to be moderate among these HF patients. Periodic HRQoL assessment is recommended for HF patients to minimize their physical and psychological concerns, particularly for patients with low education levels and female patients.
Tài liệu tham khảo
Savarese G, Lund LH. Global public health burden of heart failure. Card Fail Rev. 2017;3(1):7.
Alghamdi A, Algarni E, Balkhi B, Altowaijri A, Alhossan A. Healthcare expenditures associated with heart failure in Saudi Arabia: a cost of illness study. In: Healthcare, vol. 9, no. 8. Multidisciplinary Digital Publishing Institute, p. 988. 2021.
Global Health—Saudi Arabia. https://www.cdc.gov/globalhealth/countries/saudi_arabia/default.htm. Accessed 8 Nov 2021.
Saudi Arabia—World Health Organization. https://www.who.int/nmh/countries/sau_en.pdf. Accessed 8 Nov 2021.
Global health estimates: Leading causes of DALYs. World Health Organization. https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates/global-health-estimates-leading-causes-of-dalys. Accessed 10 Nov 2021.
WHO. Noncommunicable diseases: mortality. https://www.who.int/data/gho/data/indicators/indicator-details/GHO/probability-of-dying-between-exact-ages-30-and-70-from-any-of-cardiovascular-disease-cancer-diabetes-or-chronic-respiratory-(-). Accessed 10 Nov 2021.
AlHabib KF, Elasfar AA, AlBackr H, AlFaleh H, Hersi A, AlShaer F, Kashour T, AlNemer K, Hussein GA, Mimish L. Design and preliminary results of the heart function assessment registry trial in Saudi Arabia (HEARTS) in patients with acute and chronic heart failure. Eur J Heart Fail. 2011;13(11):1178–84.
Sato N, Kajimoto K, Asai K, Mizuno M, Minami Y, Nagashima M, Murai K, Muanakata R, Yumino D, Meguro T, Kawana M, Investigators ATTEND. Acute decompensated heart failure syndromes (ATTEND) registry. A prospective observational multicenter cohort study: rationale, design, and preliminary data. Am Heart J. 2010;159(6):949–55.
Adams KF Jr, Fonarow GC, Emermann CL. Rationale, design and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National registry (ADHERE). Am Heart J. 2005;149:209–16.
Gheorghiade M, Abraham WT, Albert NM, Greenberg BH, O’Connor CM, She L, Stough WG, Yancy CW, Young JB, Fonarow GC, OPTIMIZE-HF Investigators and Coordinators. Systolic blood pressure at admission, clinical characteristics, and outcomes in patients hospitalized with acute heart failure. JAMA 2006;296(18):2217–26.
Nieminen MS, Brutsaert D, Dickstein K, Drexler H, Follath F, Harjola VP, Hochadel M, Komajda M, Lassus J, Lopez-Sendon JL, Ponikowski P, Tavazzi L. EuroHeart Failure Survey II (EHFS II): a survey on hospitalized acute heart failure patients: description of population. Eur Heart J. 2006;27(22):2725–36.
Abdulaziz Al Dawish M, Alwin Robert A, Braham R, Abdallah Al Hayek A, Al Saeed A, Ahmed Ahmed R, Sulaiman Al Sabaan F. Diabetes mellitus in Saudi Arabia: a review of the recent literature. Curr Diabetes Rev. 2016;12(4):359–68.
Guy GW, Nunn AV, Thomas EL, Bell JD. Obesity, diabetes and longevity in the Gulf: is there a Gulf Metabolic Syndrome? Int J Diabetes Mellitus. 2009;1(1):43–54.
Algabbani AM, Almubark R, Althumiri N, Alqahtani A, BinDhim N. The prevalence of cigarette smoking in Saudi Arabia in 2018. Food Drug Regul Sci J. 2018;1(1):1–1.
Salyer J, Flattery M, Lyon DE. Heart failure symptom clusters and quality of life. Heart Lung. 2019;48(5):366–72.
Van Jaarsveld CH, Sanderman R, Miedema I, Ranchor AV, Kempen GIJM. Changes in health-related quality of life in older patients with acute myocardial infarction or congestive heart failure: a prospective study. J Am Geriatr Soc. 2001;49(8):1052–8.
Zambroski CH, Moser DK, Bhat G, Ziegler C. Impact of symptom prevalence and symptom burden on quality of life in patients with heart failure. Eur J Cardiovasc Nurs. 2005;4(3):198–206.
Rodríguez-Artalejo F, Guallar-Castillón P, Pascual CR, Otero CM, Montes AO, García AN, Conthe P, Chiva MO, Banegas JR, Herrera MC. Health-related quality of life as a predictor of hospital readmission and death among patients with heart failure. Arch Intern Med. 2005;165(11):1274–9.
Pelegrino VM, Dantas RAS, Clark AM. Health-related quality of life determinants in outpatients with heart failure. Rev Lat Am Enfermagem. 2011;19:451–7.
Son YJ, Song Y, Nam S, Shin WY, Lee SJ, Jin DK. Factors associated with health-related quality of life in elderly Korean patients with heart failure. J Cardiovasc Nurs. 2012;27(6):528–38.
Chung ML, Moser DK, Lennie TA, Frazier SK. Perceived social support predicted quality of life in patients with heart failure, but the effect is mediated by depressive symptoms. Qual Life Res. 2013;22(7):1555–63.
Heo S, Lennie TA, Okoli C, Moser DK. Quality of life in patients with heart failure: ask the patients. Heart Lung. 2009;38(2):100–8.
Sauser K, Spertus JA, Pierchala L, Davis E, Pang PS. Quality of life assessment for acute heart failure patients from emergency department presentation through 30 days after discharge: a pilot study with the Kansas City Cardiomyopathy Questionnaire. J Cardiac Fail. 2014;20(1):18–22.
Fotos NV, Giakoumidakis K, Kollia Z, Galanis P, Copanitsanou P, Pananoudaki E, Brokalaki H. Health-related quality of life of patients with severe heart failure. A cross-sectional multicentre study. Scand J Caring Sci. 2013;27(3):686–94.
Ducharme A, Doyon O, White M, Rouleau JL, Brophy JM. Impact of care at a multidisciplinary congestive heart failure clinic: a randomized trial. CMAJ. 2005;173(1):40–5.
AbuRuz ME, Alaloul F, Saifan A, Masa’Deh R, Abusalem S. Quality of life for Saudi patients with heart failure: a cross-sectional correlational study. Global J Health Sci. 2016;8(3):49.
Saudi Ministry of Health. Statistical yearbook 2017. https://www.moh.gov.sa/en/Ministry/Statistics/book/Documents/Statistical-Yearbook-1438-Appendix.pdf. Accessed 11 Nov 2021.
General Authority for Statistics. Kingdom of Saudi Arabia. Qassim region. https://www.stats.gov.sa/en/13. Accessed 11 Nov 2021.
Population in Al-Qaseem region by gender, age group, and nationality (Saudi/Non-Saudi). General Authority for Statistics. Kingdom of Saudi Arabia. https://www.stats.gov.sa/en/5725. Accessed 11 Nov 2021.
Household Income and Expenditure Survey. General Authority for Statistics. Kingdom of Saudi Arabia. https://www.stats.gov.sa/ar/37. Accessed 11 Nov 2021.
Buraidah City Profile. M Ministry of Municipal and Rural Affairs. United Nations Human Settlements Programme (UN-Habitat). ISBN: 978-603-8279-03-8. 2019. https://unhabitat.org/sites/default/files/2020/04/buraidah.pdf. Accessed 11 Nov 2021.
Coons SJ, Alabdulmohsin SA, Draugalis JR, Hays RD. Reliability of an Arabic version of the RAND-36 Health Survey and its equivalence to the US-English version. Med Care. 1998;36:428–32.
Ware JE Jr, Sherbourne CD. The MOS 36-Item Short-Form Health Survey (SF-36): I. Conceptual framework and item selection author (s). Med Care. 1992;30(6):473–83.
Gandek B, Sinclair SJ, Kosinski M, Ware JE Jr. Psychometric evaluation of the SF-36® health survey in medicare managed care. Health Care Financ Rev. 2004;25(4):5.
Brazier JE, Harper R, Jones NM, O’cathain A, Thomas KJ, Usherwood T, Westlake L. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ. 1992;305(6846):160–4.
Lahoud R, Chongthammakun V, Wu Y, Hawwa N, Brennan DM, Cho L. Comparing SF-36® scores versus biomarkers to predict mortality in primary cardiac prevention patients. Eur J Intern Med. 2017;46:47–55.
Zurita-Cruz JN, Manuel-Apolinar L, Arellano-Flores ML, Gutierrez-Gonzalez A, Najera-Ahumada AG, Cisneros-González N. Health and quality of life outcomes impairment of quality of life in type 2 diabetes mellitus: a cross-sectional study. Health Qual Life Outcomes. 2018;16(1):1–7.
Roger VL. Epidemiology of heart failure. Circ Res. 2013;113(6):646–59.
Riedinger MS, Dracup KA, Brecht ML, Investigators SOLVD. Quality of life in women with heart failure, normative groups, and patients with other chronic conditions. Am J Crit Care. 2002;327(3):211–9.
Majani G, Pierobon A, Giardini A, Callegari S, Opasich C, Cobelli F, Tavazzi L. Relationship between psychological profile and cardiological variables in chronic heart failure. The role of patient subjectivity. Eur Heart J. 1999;20(21):1579–86.
Sneed NV, Paul S, Michel Y, VanBakel A, Hendrix G. Evaluation of 3 quality of life measurement tools in patients with chronic heart failure. Heart Lung. 2001;30(5):332–40.
Alla F, Briançon S, Guillemin F, Juillière Y, Mertès PM, Villemot JP, Zannad F, Investigators EPICAL. Self-rating of quality of life provides additional prognostic information in heart failure. Insights into the EPICAL study. Eur J Heart Fail. 2002;4(3):337–43.
Scott LD. Caregiving and care receiving among a technologically dependent heart failure population. Adv Nurs Sci. 2000;23(2):82–97.
Tarekegn GE, Gezie LD, Birhan TY, Ewnetu F. Health-related quality of life among heart failure patients attending an outpatient clinic in the University of Gondar Comprehensive Specialized Hospital Northwest, Ethiopia, 2020: using structural equation modeling approach. Patient Relat Outcome Meas. 2021;12:279.
Grady KL, Jalowiec A, White-Williams C, Pifarre R, Kirklin JK, Bourge RC, Costanzo MR. Predictors of quality of life in patients with advanced heart failure awaiting transplantation. J Heart Lung Transplant. 1995;14(1 Pt 1):2–10.
Boyd KJ, Murray SA, Kendall M, Worth A, Benton TF, Clausen H. Living with advanced heart failure: a prospective, of patients and their carers based study community. Eur J Heart Fail. 2004;6(5):585–91.
Gorkin L, Norvell NK, Rosen RC, Charles E, Shumaker SA, McIntyre KM, Capone RJ, Kostis J, Niaura R, Woods P, Hosking J, Investigators SOLVD. Assessment of quality of life as observed from the baseline data of the Studies of Left Ventricular Dysfunction (SOLVD) trial quality-of-life substudy. Am J Cardiol. 1993;71(12):1069–73.
Nordgren L, Sörensen S. Symptoms experienced in the last six months of life in patients with end-stage heart failure. Eur J Cardiovasc Nurs. 2003;2(3):213–7.
Lainscak M, Keber I. Patient’s view of heart failure: from the understanding to the quality of life. Eur J Cardiovasc Nurs. 2003;2(4):275–81.
Schiff GD, Fung S, Speroff T, McNutt RA. Decompensated heart failure: symptoms, patterns of onset, and contributing factors. Am J Med. 2003;114(8):625–30.
Moradi M, Daneshi F, Behzadmehr R, Rafiemanesh H, Bouya S, Raeisi M. Quality of life of chronic heart failure patients: a systematic review and meta-analysis. Heart Fail Rev. 2020;25(6):993–1006.
Alkatheri AM, Albekairy AM. Does the patients’ educational level and previous counseling affect their medication knowledge? Ann Thorac Med. 2013;8(2):105.
Barbareschi G, Sanderman R, Leegte IL, Van Veldhuisen DJ, Jaarsma T. Educational level and the quality of life of heart failure patients: a longitudinal study. J Cardiac Fail. 2011;17(1):47–53.
Sui X, Gheorghiade M, Zannad F, Young JB, Ahmed A. A propensity matched study of the association of education and outcomes in chronic heart failure. Int J Cardiol. 2008;129(1):93–9.
Pilote L, Dasgupta K, Guru V, Humphries KH, McGrath J, Norris C, et al. A comprehensive view of sex-specific issues related to cardiovascular disease. CMAJ. 2007;176(6):S1–44. https://doi.org/10.1503/cmaj.051455.
Möller-Leimkühler AM. Women with coronary artery disease and depression: a neglected risk group. World J Biol Psychiatry. 2008;9(2):92–101. https://doi.org/10.1080/15622970701275281.
Norris CM, Ghali WA, Galbraith PD, Graham MM, Jensen LA, Knudtson ML, Investigators APPROACH. Women with coronary artery disease report worse health-related quality of life outcomes compared to men. Health Qual Life Outcomes. 2004;2:21. https://doi.org/10.1186/1477-7525-2-21.
Kazemi-Saleh D, Pishgoo B, Farrokhi F, Fotros A, Assari S. Sexual function and psychological status among males and females with ischemic heart disease. J Sex Med. 2008;5(10):2330–7. https://doi.org/10.1111/j.1743-6109.2008.00788.x.
Möller-Leimkühler AM. Higher comorbidity of depression and cardiovascular disease in women: a biopsychosocial perspective. World J Biol Psychiatry. 2010;11(8):922–33. https://doi.org/10.3109/15622975.2010.523481.