Journal List > Korean J Adult Nurs > v.25(1) > 1094323

Lee and Seo: Factors Influencing Health-related Quality of Life in Patients with Atrial Fibrillation

Abstract

Purpose

The purpose of this study was to investigate the factors that influence health-related quality of life in patients with atrial fibrillation.

Methods

The subjects were 150 outpatients with atrial fibrillation who visited the cardiology clinic of a university hospital in U city. The instruments used for this study were Mhel Uncertainty in Illness Scale (MUIS), Center for Epidemiologic Studies-Depression Scale (CES-D), State Trait Anxiety Inventory (STAI), and the Short-Form-36 Health Survey (SF-36) Korean version II. The date were analyzed by ANOVA, Pearson-correlation coefficient, and hierachial multiple regression using SPSS/WIN 18.0.

Results

The mean score of physical health-related quality of life (PCS) was 38.92±6.22 and mental health-related quality of life (MCS) was 41.49±5.71. Physical and Mental health-related quality of life had the significant correlations with uncertainty, anxiety and depression. In multiple regression analysis, physical health-related quality of life was significantly influenced by duration of disease, NYHA class, uncertainty. Mental health-related quality of life was significantly influenced by family income, NYHA class, anxiety and depression.

Conclusion

These results suggest that these influencing factors should be consider in developing the nursing interventions to improve the health-related quality of life in patients with atrial fibrillation.

REFERENCES

Baek K. H.., Son Y. J.2008. Relationships between symptom experience and quality of life in patients with atrial fibrillation. The Korean Journal of Fundamentals of Nursing. 15:485–494.
Chon K. K.., Rhee M. K.1992. Preliminary development of Korean version of CES-D. Korean Journal of Clinical Psychology. 11:65–76.
Christman N.., McConnell E. A.., Pfeiffer C.., Weber K.., Schmitt M.., Ries J.1988. Uncertainty, coping, and distress following myocardial infarction: Transition from hospital to home. Research in Nursing and Health. 11:71–82.
crossref
Dolgin M.1994. Nomenclature and criteria for diagnosis of disease of the heart and great vessels. 9th ed.Boston, MA: Little Brown & Company.
Go A. S.., Hylek E. M.., Phillips K. A.., Chang Y.., Henault L. E.., Selby J. V., et al. 2001. Prevalence of diagnosed atrial fibrillation in adults. The Journal of the American Medical Association. 285:2370–2375.
crossref
Gottlieb S. S.., Khatta M.., Friedmann E.., Einbinder L.., Karzen S.., Baker B., et al. 2004. The influence of age, gender, and race on the prevalence of depression in heart failure patients. Journal of the American College of Cardiology. 43:1542–1549.
crossref
Jeong J. H.2001. Incidence of and risk factors for atrial fibrillation in screening test for 40 years and older adults. The Korean Journal of Medicine. 61:489–495.
Kang Y. H.2005. The relationships among uncertainty, appraisal of uncertainty, depression, anxiety and perceived health status in patients with atrial fibrillation. Journal of Korean Academy of Adult Nursing. 17:230–238.
Kang Y. H.2009. Gender and culture differences in the quality of life among Americans and Koreans with atrial fibrillation. Nursing and Health Sciences. 11:301–305.
crossref
Kim J. T.., Shin D. K.1978. A study based on the standardization of the STAI for Korea. The New Medical Journal. 21:69–75.
Kim S. Y.1999. The effects of a cardiac rehabilitation educational program on anxiety, health compliance and quality of life of the patient with cardiac valve replacement. The Korean Journal of Rehabilitation Nursing. 2:153–162.
Ladwig K. H.., Lehmacher W.., Roth R.., Breithardt G.., Budde T.., Borggrefe M.1992. Factor which provoke post-infarction depression: Results from the post-infarction late potential study(PILP). Journal of Psychosomatic Research. 36:723–729.
Mishel M. H.., Braden C. J.1987. Uncertainty: A mediator between support and adjustment. Western Journal of Nursing Research. 9(1):43–57.
Mishel M. H.., Hostetter T.., King B.., Graham V.1984. Predictors of psychosocial adjustment in patients newly diagnosed with gynecological cancer. Cancer Nursing. 7:291–299.
crossref
Mun Y. S.2012. The correlation among uncertainty, self care agency and quality of life in elderly patients underwent percutaneous coronary intervention. Unpublished master's thesis, Catholic University of Pusan, Busan.
Oh J. K.., Appleton C. P.., Hatle L. K.., Nishimura R. A.., Seward J. B.., Tajik A. J.1997. The noninvasive assessment of left ventricular diastolic function with two-dimensional and Doppler echocardiography. Journal of the American Society of Echocardiography. 10:246–270.
crossref
Ong L.., Cribbie R.., Harris L.., Dorian P.., Newman D.., Mangat I., et al. 2006. Psychological correlates of quality of life in atrial fibrillation. Quality of Life Research. 15:1323–1333. http://dx.doi.org/10.1007/s11136-006-0029-5.
crossref
Page R. L.2004. Newly diagnosed atrial fibrillation. The New England Journal of Medicine. 351:2408–2416.
crossref
Park S. K.., Kim H. S.., Cho I. S.., Ham O. K.2009. Gender differences in factors influencing quality of life among patients with coronary artery disease. Journal of Korean Academy of Fundamentals of Nursing. 16:497–505.
Radloff L. S.1977. The CES-D scale: A new self-report depression scale for research in the general population. Applied Psychological Measurement. 1:385–401.
Rector T. S.., Tschumperlin L. K.., Kubo S. H.., Bank A. J.., Francis G. S.., McDonald K. M., et al. 1995. Use of the living with heart failure questionnaire to ascertain patients' perspectives on improvement in quality of life versus risk of drug-induced death. Journal of Cardiac Failure. 1:201–206.
crossref
Reynolds M. R.., Lavelle T.., Essebag V.., Cohen D. J.., Zimetbaum P.2006. Influence of age, sex, and atrial fibrillation recurrence on quality of life outcomes in a population of patients with new-onset atrial fibrillation: The fibrillation registry assessing costs, therapies, adverse events and life-style(FRACTAL) study. American Heart Journal. 152:1097–1103. http://dx.doi.org/10.1016/j.ahj.2006.08.011.
So H. S.1996. Changes on the uncertainty, ways of coping, and depression for patients with uterine cervical cancer during the early adaptation process: A longitudinal study. Unpublished doctoral dissertation, Yonsei University, Seoul.
Spielberger C. D., Gorsuch R. L., Lushene R. E., editors1971. STAI manual for the S-T-A-I ("self-evaluation Questionnaire"). Palo Alto, CA: Consulting Psychologist Press.
Thrall G.., Lip G. Y.., Carroll D.., Lane D.2007. Depression, anxiety, and quality of life in patients with atrial fibrillation. Chest. 132:1259–1264. http://dx.doi.org/10.1378/chest.07-0036.
crossref
Ware J. E.., Sherbourne C. D.1992. The MOS 36-item short form health survey (SF-36) I: Conceptual framework and item selection. Medical Care. 30:473–483.
Ware J. E., Kosinski M., Keller S. D., editors1994. SF-36 physical and mental health summary scales; A user's manual. Boston, MA: New England Medical Center.
Won S. J.2010. Health related quality of life in patient with cardiac surgery. Unpublished master's thesis, Konkuk University, Seoul.
Yoon J. R.1998. Some of the problems in the measurement of quality of life: Development of a new measurement. Journal of The Korean Academy of Family Medicine. 19:1016–1024.

Table 1.
Differences of Health-related Quality of Life according to Subjects' Characteristics (N=150)
Characteristics Categories n(%) PCS t or F p MCS t or F p
M±SD M±SD
Gender Male 77 (51.3) 39.65±6.65 1.49 .138 41.17±5.81 -0.69 .493
Female 73 (48.7) 38.14±5.67 41.82±5.63
Age (year) <50 15 (10.0) 43.20±5.11 5.65 .001 42.71±3.86 3.42 .019
50~59 49 (32.7) 38.88±6.39 41.60±5.94
60~69 48 (32.0) 39.80±5.73 42.84±4.23
≥70 38 (25.3) 36.17±5.91 39.15±6.96
Education None 10 (6.7) 32.57±4.88 6.86 <.001 38.78±6.19 1.06 .380
Elementary school 51 (34.0) 38.46±4.76 40.83±5.97
Middle school 50 (33.3) 38.24±5.59 42.15±4.89
High school 29 (19.3) 42.98±6.70 42.07±5.12
≥College 10 (6.7) 39.22±8.87 42.51±8.76
Religion Have 106 (70.7) 38.32±6.16 -1.84 .068 41.23±5.77 -0.85 .396
Haven't 44 (29.3) 40.36±6.18 42.10±5.59
Marital status Yes 119 (79.3) 39.40±5.13 1.36 .182 42.00±5.22 2.19 .030
No 31 (20.7) 37.07±9.17 39.51±7.05
Occupation Have 74 (49.3) 38.87±6.34 -0.09 .928 41.64±4.66 0.33 .744
Haven't 76 (50.7) 38.96±6.14 41.34±6.61
Family income (10,000 won) <100 30 (20.0) 36.07±5.58 3.43 .019 37.44±4.28 7.37 < <.001
100~199 46 (30.7) 38.63±5.65 42.66±6.34
200~299 56 (37.3) 40.20±6.41 42.06±5.35
≥300 18 (12.0) 40.41±6.79 43.42±4.24
Living together with family Yes 129 (86.0) 39.33±5.41 1.35 .190 41.95±5.41 2.51 .013
No 21 (14.0) 36.41±9.63 38.63±6.78
Duration of disease (year) <1 28 (18.7) 40.02±5.05 7.65 <.001 40.68±4.76 1.57 .199
1~2 79 (52.7) 40.22±5.66 42.41±5.86
3~5 27 (18.0) 37.47±7.49 39.98±5.69
≥6 16 (10.6) 33.01±4.75 40.90±6.21
Number of admission 0~1 76 (50.7) 39.72±6.44 1.58 .210 41.85±5.90 0.33 .717
2~3 36 (24.0) 38.67±5.74 41.24±6.15
≥4 38 (25.3) 37.56±6.10 40.98±4.94
Classification of atrial fibrillation Paroxysmal 54 (36.0) 39.37±6.65 0.66 .509 41.41±6..31 -0.13 .901
Persistent 96 (64.0) 38.67±5.99 41.53±5.38
Left ventricular ejection fraction (%) <55 99 (66.0) 37.59±6.32 -3.80 <.001 40.84±6.01 -1.94 .054
≥55 51 (34.0) 41.49±5.18 42.74±4.89
NYHA class Class I 74 (49.3) 41.11±5.59 14.03 <.001 42.44±4.89 5.47 .005
Class II 63 (42.0) 37.57±5.83 41.30±6.41
Class III 13 (8.7) 33.00±6.14 36.95±4.43
Underlying heart disease Yes 72 (48.0) 38.04±6.07 -1.67 .097 40.92±5.93 -1.17 .243
No 78 (52.0) 39.73±6.28 42.01±5.49
Hyperthyroidism Yes 24 (16.0) 37.44±6.56 -1.27 .205 40.56±6.78 -0.87 .387
No 126 (84.0) 39.20±6.14 41.66±5.50

NYHA=New York Heart Association; PCS=physical component summary; MCS=mental component summary.

Table 2.
Health-related Quality of Life, Uncertainty, Anxiety and Depression of the Subjects (N=150)
Variables M±SD Possible range Actual range
Health-related quality of life
  PCS 38.92±6.22 0~100 25.90~57.85
  MCS 41.49±5.71 0~100 26.37~60.59
  Physical function 43.27±22.90 0~100 5.00~100.00
  Role limitation-physical 59.29±18.07 0~100 12.50~100.00
  Bodily pain 56.31±21.85 0~100 12.00~100.00
  General health 48.37±13.98 0~100 10.00~85.00
  Vitality 41.46±14.65 0~100 6.25~75.00
  Social function 66.50±14.65 0~100 25.00~100.00
  Role limitation-emotion 58.50±19.27 0~100 16.67~100.00
  Mental health 48.23±14.25 0~100 10.00~90.00
Uncertainty 38.82±6.56 0~88 26~53
  Ambiguity 15.27±2.87 0~32 9~22
  Complexity 6.35±1.58 0~16 2~9
  Inconsistency 7.75±1.73 0~20 4~13
  Unpredictability 9.45±2.19 0~20 5~16
Anxiety 41.17±6.13 20~80 28~52
Depression 19.66±7.25 0~60 6~34

PCS=physical component summary; MCS=mental component summary.

Table 3.
Correlations between Subjects' Uncertainty, Anxiety, Depression and Health-related Quality of Life (N=150)
Variables Health related quality of life
PCS MCS
r p r p
Uncertainty -.49 <.001 -.34 <.001
Anxiety -.37 <.001 -.44 <.001
Depression -.41 <.001 -.42 <.001

PCS=physical component summary; MCS=mental component summary.

Table 4.
Factors Influencing Health-related Quality of Life in Patients with Atrial Fibrillation (N=150)
Variables β p R2 change F change p
Physical component summary
Step 1     .10 5.14 .002
  Age -.08 .552
  Education .20 .063
  Monthly income .08 .505
Step 2     .17 11.39 <.001
  Duration of disease -.20 .023
  LVEF .11 .218
  NYHA class -.24 .004
Step 3     .10 7.65 <.001
  Uncertainty -.28 .002
  Anxiety -.06 .502
  Depression -.14 .097
Mental component summary
Step 1     .12 4.69 .001
  Age .11 .349
  Marital status -.07 .443
  Family income .33 .006
  Living together with family -.14 .117
Step 2     .03 4.15 .001
  NYHA class -.16 .044
Step 3     .15 9.83 <.001
  Uncertainty -.14 .102
  Anxiety -.24 .008
  Depression -.19 .040

LVEF=left ventricular ejection fraction; NYHA=New York Heart Association.

LVEF (0:<55%, 1:≥55%);

Marital status, Living together with family (0: Yes, 1: No).

TOOLS
Similar articles