Abstract 14322: The Relationship Between Self-care and Health-related Quality Life in Patients With Heart Failure Differs by Age

Abstract

Background: Although poor self-care is expected to negatively influence health-related quality of life (HRQOL), this relationship is not consistent. The possible reason might be related that older people reconceptualize or change their expectations for HRQOL. Therefore, vigilant monitoring daily symptom status and other self-care activity might not benefit for older patients with HF to improve their HRQOL. Objective: To examine whether the relationship between self-care and HRQOL differs between younger (age <65 years) and older patients (age≥65 years) with HF. Methods: A total of 138 patients were included in this study (60 years, 29% female, 12.3% NYHA functional class III/IV). Patients were asked to complete the Kansas City Cardiomyopathy Questionnaire and the self-care maintenance of the Self-care HF index to measure overall HRQOL and self-care maintenance. To examine the association between self-care maintenance and HRQOL in younger and older patients, two separate linear regressions were performed after controlling for covariates (age, gender, marital status, NYHA functional class, perceived control, and social support). Results: Self-care maintenance and overall HRQOL were not different between younger (n=90) and older patients (n=48). However, self-care maintenance was an independent predictor of overall HRQOL in only older patients, but not their younger counterparts. In older patients, better self-care maintenance was associated with poorer overall HRQOL (β=-0.37, p=0.03). Conclusions: We found that the relationship between self-care and HRQOL is different between younger and older patients with HF. This finding indicates that improving self-care alone does not necessarily improve HRQOL in older patients so that interventions aimed to enhance HRQOL in older patients need to include strategies considering older patients’ conceptualization for HRQOL.