Illness acceptance, medication adherence and the quality of life in patients with heart failure: A path analysis of a conceptual model

Abstract

Heart failure (HF) is a chronic disease that negatively affects different aspects of the patients' lives, diminishing their quality of life. This research studied factors that impact the health-related quality of life (HRQoL) of patients with HF, particularly medication adherence and acceptance of illness. In this cross-sectional study, data were collected from 273 patients admitted to a tertiary hospital with the diagnosis of HF. Participants' level of illness acceptance, medication adherence, and HRQoL were assessed using validated questionnaires, and data were analyzed using the regression path analysis. There was found a moderate level of acceptance of illness (24.9 ± 6.79) and low levels of medication adherence (3.44 ± 3.15) and HRQoL (53.81 ± 17.99) among participants. Gender, education, income, history of coronary artery bypass (CABG), the New York Heart Association (NYHA) class, acceptance of illness, and medication adherence were statistically significantly associated with HRQoL. Patients with diminished HRQoL were more likely to be female, less educated, have lower income, higher NYHA class, no prior CABG, low medication adherence, and low level of acceptance of illness. The final path model demonstrated a good fit with the data (χ^2/df = 1.70, CFI = 0.92, RMSEA = 0.05, and p = 0.01). Health care providers should target and promote medication adherence and the acceptance of illness as modifiable factors to help improve the HRQoL of patients with HF.