Modifiable Factors Associated with Quality of Life at 3 Months and the Mediator Effect of Functional Status in Patients with Heart Failure

Abstract

Objectives To examine modifiable factors associated with quality of life (QOL) at 3 months and the mediator effect of functional status at 3 months on the relationship between baseline heart failure (HF) symptoms and QOL at 3 months in patients with HF. Background Good QOL in patients with HF is as value as or more valuable than longer survival. Thus, it is important to know modifiable factors associated with QOL. HF symptoms have been suggested to impact functional status, and, in turn, QOL, but the mediator effect of functional status on the relationship between HF symptoms and QOL has not been frequently examined. Methods and Materials In a descriptive, correlational study, data on QOL (the EQ-VAS) and functional status (the Korean Activity Scale/Index) were collected at 3 months; and HF symptoms (the Symptom Status Questionnaire-Heart Failure), depressive symptoms (the Patient Health Questinnaire-9), and sample characteristics, such as age, comorbidity, and New York Heart Association (NYHA) class (severity of disease), were collected at baseline from 65 patients with HF (Mean age: 75 years, 60% males, and 31% NYHA III). Multiple regression and Process Macro for SPSS were used to analyze the data. Results In multiple regression analysis, among the modifiable factors of HF symptoms, functional status, depressive symptoms, and severity of disease, only functional status at 3 months (p = .024) was significantly associated with QOL at 3 months, controlling for age and comorbidities (F = 2.557, p = .029, R2 = .209). Better functional status was associated with better QOL. In the Process Macro analysis, baseline HF symptoms (p = .012) and age (p Conclusion Functional status was directly and indirectly associated with QOL, while HF symptoms only indirectly predicted QOL through the effects on functional status. Clinicians and researcher need to assess and manage both HF symptoms and functional status to improve QOL in patients with HF. Further studies are needed to examine whether improvements in HF symptoms lead to improvements in functional status, and in turn, improvements in QOL.