Does improvement in self-management skills predict improvement in quality of life and depressive symptoms? A prospective study in patients with heart failure up to one year after self-management education

Gunda Musekamp,Jürgen Bengel,Bettina Seekatz,Karin Meng,Hermann Faller,Michael Schuler

doi:10.1186/s12872-017-0486-5

Gunda Musekamp, Jürgen Bengel + Show 4 more

Open Access

https://doi.org/10.1186/s12872-017-0486-5

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Abstract

BackgroundHeart failure (HF) patient education aims to foster patients’ self-management skills. These are assumed to bring about, in turn, improvements in distal outcomes such as quality of life. The purpose of this study was to test the hypothesis that change in self-reported self-management skills observed after participation in self-management education predicts changes in physical and mental quality of life and depressive symptoms up to one year thereafter.MethodsThe sample comprised 342 patients with chronic heart failure, treated in inpatient rehabilitation clinics, who received a heart failure self-management education program. Latent change modelling was used to analyze relationships between both short-term (during inpatient rehabilitation) and intermediate-term (after six months) changes in self-reported self-management skills and both intermediate-term and long-term (after twelve months) changes in physical and mental quality of life and depressive symptoms.ResultsShort-term changes in self-reported self-management skills predicted intermediate-term changes in mental quality of life and long-term changes in physical quality of life. Intermediate-term changes in self-reported self-management skills predicted long-term changes in all outcomes.ConclusionsThese findings support the assumption that improvements in self-management skills may foster improvements in distal outcomes.

Highlights

Heart failure (HF) patient education aims to foster patients’ self-management skills
Studies have shown that quality of life in HF patients is reduced compared to the general population or patients with other chronic conditions [14,15,16]
In a previous study in patients with different chronic disorders, we showed that short-term changes in self-reported self-management skills predicted 3-months changes in quality of life and depressive symptoms [24]

Summary

Introduction

Heart failure (HF) patient education aims to foster patients’ self-management skills. These are assumed to bring about, in turn, improvements in distal outcomes such as quality of life. In view of the aging population it will affect even more people in the future [2]. It requires multidisciplinary management programs including patient education concerning self-care/self-management [3,4,5]. Depression is common among patients with HF and worsens the prognosis [17,18,19] Both quality of life and depressive symptoms are considered important distal outcomes in patients with HF

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