Modifiable correlates of physical symptoms and health-related quality of life in patients with heart failure: A cross-sectional study

Background: Heart failure is associated with high rates of hospitalization and mortality. The majority of patients with heart failure suffer from physical symptoms, and these symptoms are strongly associated with poor health-related quality of life. To improve physical symptoms and health-related quality of life, the modifiable factors associated with physical symptoms need to be examined. Purpose: To examine modifiable psychosocial and behavioral factors associated with physical symptoms and health-related quality of life, and the mediator effects of physical symptoms on the relationships between the modifiable factors and health-related quality of life in patients with heart failure. Methods: Data on potential correlates of physical symptoms (i.e., depressive symptoms, perceived control, social support, medication adherence, sodium intake, and self-care management) were collected from 109 patients with heart failure (mean age 58 ± 14 years, 46% male, 89% New York Heart Association class II/III). Data on physical symptoms (Symptom Status Questionnaire-Heart Failure) and health-related quality of life (Minnesota Living with Heart Failure) also were collected. Simple and multiple regression analyses were used to analyze the data. Results: Among the potential correlates, depressive symptoms and sodium intake were associated with physical symptoms (F= 11.63, p< .001), and depressive symptoms and perceived control were associated with health-related quality of life (F= 9.917, p< .001). Physical symptoms mediated the relationship between depressive symptoms and health-related quality of life. Conclusion: Improving depressive symptoms and eating the appropriate amount of sodium may be primary intervention targets to improve physical symptoms. To improve health-related quality of life, depressive symptoms as well as physical symptoms need to be managed appropriately.