Perception of illness among patients with heart failure is related to their general health independently of their mood and functional capacity

Anners Lerdal,May Solveig Fagermoen,Caryl L Gay,Dag Hofoss

doi:10.1186/s41687-019-0142-1

Anners Lerdal, May Solveig Fagermoen + Show 2 more

Open Access

https://doi.org/10.1186/s41687-019-0142-1

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Abstract

PurposeTo explore the relationship between illness perceptions and self-reported general health of patients with chronic heart disease, using some core elements from the Common Sense Model.MethodsPatients with heart failure (New York Heart Association [NYHA] Functional Class I-III) from five outpatient clinics in Eastern Norway were invited to participate in this cross-sectional study. Two research nurses collected socio-demographic data (age, sex, education and work status) and standardized questionnaires in structured interviews. Patients’ self-reported general health was measured with the Euro-Qual Visual Analogue Scale (EQ-VAS), illness perceptions were measured with the 8-item Brief Illness Perception Questionnaire (BIPQ), and mood was assessed using the Hospital Anxiety and Depression Scale.ResultsAmong the 220 patients who were recruited into this study (98% response rate), the mean age was 67.5 years (SD ± 12.5), and 65.9% were men. Patients were classified as NYHA Class I (8.7% with no activity limitations), Class II (47.6% with slight limitations), or Class III (43.8% with marked limitations). Mean EQ-VAS score was 58.8 (SD ± 21.0). Three of the eight perception of illness items (consequences, personal control and identity) were associated with the patients’ general health rating, controlling for their NYHA Class, mood and other BIPQ items.ConclusionsOur findings suggest that patients’ perceptions of their illness have an independent and substantial relationship to the self-rated general health of patients with chronic heart failure. Peoples’ illness perceptions are beliefs that have been shown to be modifiable in clinical interventions. Thus, targeted interventions aimed to modify these, such as patient education courses, ought to be developed and tested, as they may be helpful for improving perceived health status.

Highlights

Heart failure (HF) is a severe condition affecting many people throughout the world and is the most frequent reason for hospitalization in the aging population [1]
The main finding of this study of patients with heart failure was that their cognitive illness perceptions, i.e. consequences, personal control and identity, were significantly associated with their self-reported general health, as hypothesized based on our conceptual model (Fig. 1)
The role of illness perceptions has received relatively little attention in cardiovascular disease compared to the role of depression, which has been studied for decades [20]

Summary

Introduction

Heart failure (HF) is a severe condition affecting many people throughout the world and is the most frequent reason for hospitalization in the aging population [1]. In Norway, more than 100, 000 people suffer from HF, one-third of whom are Chronic heart failure (CHF) is clinically defined as a syndrome due to abnormality in the patient’s cardiac structure or function with typical signs and symptoms due to sodium and water retention. The patient’s experience involves symptoms such as dyspnea, ankle edema and fatigue, which often result in reduced quality of life [5, 6]. Studies have reported high levels of depression and anxiety in patients with HF [7, 8]. A meta-study on HF and depression concluded that depression as a Lerdal et al Journal of Patient-Reported Outcomes (2019) 3:55 comorbid illness in heart failure has significant implications for the patient, both in terms of quality of life and health outcomes [8]

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