Elsevier

Heart & Lung

Volume 31, Issue 2, March–April 2002, Pages 94-101
Heart & Lung

Issues in Cardiovascular Nursing
Health-related quality of life and sense of coherence among elderly patients with severe chronic heart failure in comparison with healthy controls*,**

https://doi.org/10.1067/mhl.2002.122821Get rights and content

Abstract

Objective: To describe health-related quality of life (QoL) and sense of coherence (SOC) in a group of elderly people with moderate to severe chronic heart failure and to make comparisons with a healthy sex- and age-matched control group. Methods: Patients (n = 94), with a mean age of 81 years, hospitalized for chronic heart failure with New York Heart Association functional classification III to IV were age- and sex-matched to a healthy control group. The instruments used were the 36-Item Short Form Health Survey (SF-36) and SOC. Results: The patients had lower levels of health-related QoL scores (SF-36) but high and similar scores of SOC compared with the controls. There were, however, significant positive correlations between the SOC scores and the emotional dimensions in the SF-36 instrument. Conclusion: The findings from this study indicate that old age and severe chronic heart failure were associated with limited functional abilities and impaired health-related QoL but also with internal resources such as SOC. (Heart Lung® 2002; 31:94-101.)

Section snippets

Methods

The study was conducted at the Sahlgrenska University Hospital (SU)/Sahlgrenska, Göteborg, Sweden, which is both a secondary-care and a tertiary hospital. The majority of patients in need of acute hospital care for CHF are treated on internal medicine wards. The study protocol was approved by the Ethics Committee at Sahlgrenska University Hospital. The investigation conforms to the principles outlined in the Declaration of Helsinki.20

The inclusion criteria were as follows: aged 65 years or

Results

Scores from the 8 dimensions of the SF-36 instrument for patients and matched controls are shown in Table II.

. Comparison of the SF-36 instrument's 8 dimensions in the patient group and the healthy control group

Instrument (SF-36, Mean ±SD)Patients (n = 92)Controls (n = 92)Difference (Mann-Whitney U test)
Physical function39.9 ± 22.769.0 ± 30.1
Role physical25.3 ± 33.979.6 ± 35.7
Bodily pain61.8 ± 31.178.4 ± 27.1*
General health43.8 ± 21.075.9 ± 22.3
Vitality35.4 ± 23.768.3 ± 25.7
Social function

Discussion

The findings from this study reveal that the patients with CHF had lower levels of health-related QoL scores (SF-36) compared with the healthy control group. On the other hand, they had similarly high scores of SOC.

In this study, the patients scored particularly low on the SF-36 in the physical dimension, such as physical function, role physical, general health, and vitality. It can be seen that people with severe CHF suffer from considerable functional losses. The patients in this study were

Acknowledgements

We appreciate all the help that we received from Lisbeth Carlsson, Rachel Wessby, Ing-Marie Forsell, and all the nurses and physicians at the Department of Medicine at the Sahlgrenska University Hospital.

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    *

    This study was supported by grants from the Swedish Medical Research Council (Grant Nos. B 96-27X-11652-01 A, K 97-27X-11652-02BK, K97-27X-11652-02B, and K98-27X-11652-03C) and the Swedish Foundation for Health Care Sciences and Allergy Research.

    **

    Reprint requests: Inger Ekman, RN, PhD, Sahlgrenska academy at Göteborg University, Faculty of Health and Caring Sciences, Institute of Nursing, Billerudsgatan 1, S-416 75 Göteborg, Sweden.

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