Factors associated with perceived control and the relationship to quality of life in patients with heart failure

Seongkum Heo, Terry A. Lennie, Susan J. Pressler, Sandra B. Dunbar, Misook L. Chung, Debra K. Moser

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Background and purpose: Health-related quality of life (HRQOL) is as important as survival to patients with heart failure (HF). Perceptions of loss of control are common in HF and negatively affect HRQOL. Knowledge of modifiable factors associated with perceived control could guide the development of interventions to improve perceived control and thus HRQOL. Accordingly, this study examined factors related to perceived control and the relationship between perceived control and HRQOL. Methods: Patients (N=232, mean age 6112, 67% male, 78% Caucasian) provided data on HRQOL (Minnesota Living with Heart Failure questionnaire), perceived control (Control Attitudes Scale-Revised), and factors possibly associated with perceived control (knowledge and barriers (Heart Failure Knowledge and Barriers to Adherence Scale), attitudes (Dietary Sodium Restriction Questionnaire), and social support (Multidimensional Scale of Perceived Social Support)). Patients also provided data on depressive symptoms, which were a covariate of HRQOL. Hierarchical multiple regression analysis was used to analyze the data. Results: Fewer barriers to following a low sodium diet, more positive attitudes toward following a low sodium diet, and better social support were related to higher perceived control (F=7.54, R2=0.17, p<0.001). Perceived control was independently associated with HRQOL, controlling for depressive symptoms, New York Heart Association functional class, age, gender, and all variables possibly associated with perceived control (F=29.67, R2=0.55, p<0.001). Conclusions: Interventions targeting attitudes and barriers to a low sodium diet and social support may improve perceived control and, in turn, HRQOL.

Original languageEnglish
Pages (from-to)137-144
Number of pages8
JournalEuropean Journal of Cardiovascular Nursing
Issue number2
StatePublished - Apr 23 2015

Bibliographical note

Funding Information:
Funding for this study came from an American Heart Association Postdoctoral Fellowship to Seongkum Heo; the National Institutes of Health (NIH), National Institute of Nursing Research (NINR) R01 NR009280 to Terry Lennie; the Philips Medical-AACN Research Award and Center grant NIH, NINR, 1P20NR010679, to Debra Moser; and, in part, PHS Grant M01 RR0039 from the General Clinical Research Center program, and PHS Grant UL1 RR025008 from the Clinical and Translational Science Award program, NIH, National Center for Research Resources, to David Stephens, and the Atlanta Veterans Administration Medical Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NINR or the NIH.


  • Heart failure
  • attitudes
  • barriers
  • perceived control
  • quality of life

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medical–Surgical
  • Advanced and Specialized Nursing


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