Health-related quality of life among the elderly with heart failure
a generic measurement
Keywords:
Aged, Aging, Heart failure, Quality of life, QuestionnairesAbstract
CONTEXT AND ObjeCtive: Health-related quality-of-life (HRQoL) instruments have been greatly used among patients with heart failure (HF), although few of them are specific for elderly people. Among the generic instruments, the Medical Study 36-item Short-Form Health Survey (SF-36) is widely used. The aim here was to evaluate HRQoL among elderly individuals with HF through this generic instrument. DESIGN AND SETTING: Cross-sectional study at two university hospitals in São Paulo, Brazil. Methods: 170 elderly people with HF who were being followed up as outpatients were interviewed. To evaluate HRQoL, SF-36 was used. Results: The sample was composed of subjects with a mean age of 67.5 (± 6.2) years, with a diagnosis of HF for 65.9 (± 42.4) months, in functional class I (38.8%; 66) or II (42.9%; 73) and with reduced left ventricular ejection fraction (LVEF) (51.2%). The mental and social HRQoL domains did not seem to be compromised, since they presented high scores. Patients with HF typically had impaired physical capacity, which may explain the lower scores in the physical domain. Cronbach’s alpha coefficients were greater than 0.77 for all dimensions, except for general health status. Conclusion: The HRQoL measurements using SF-36 presented a high level of reliability when applied to Brazilian elderly individuals with HF. This population presented lower scores for the functional capacity and physical dimensions. This provides support for intervention studies aiming towards optimization of HRQoL in this group.
Downloads
References
Jacob Filho W. Envelhecimento e atendimento domiciliário. In: Duarte YA, Diogo MJD, edi- tores. Atendimento domiciliar: um enfoque gerontológico. São Paulo: Atheneu; 2000. p. 19-26.
Fayers P, Machin D. Quality of life: assessment, analysis, and interpretation. Chichester: John Willey & Sons; 1998.
Jaagosild P, Dawson NV, Thomas C, et al. Outcomes of acute exacerbation of severe congesti- ve heart failure: quality of live, resource use, and survival. SUPPORT Investigators. The Study to Understand Prognosis and Preferences for Outcomes and Risks of Treatments. Arch Intern Med. 1998;158(10):1081-9.
Jaarsma T, Halfens R, Abu-Saad HH, et al. Quality of life in older patients with systolic and diastolic heart failure. Eur J Heart Fail. 1999;1(12):151-60.
Heo S, Moser DK, Lennie TA, Zambroski CH, Chung ML. A comparison of health-related quality of life between older adults with heart failure and healthy older adults. Heart Lung. 2007;36(1):16-24.
Hunt SA, Baker DW, Chin MH, et al. ACC/AHA Guidelines for the Evaluation and Management of Chronic Heart Failure in the Adult: Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1995 Guidelines for the Evaluation and Management of Heart Failure): De- veloped in Collaboration With the International Society for Heart and Lung Transplantation; Endorsed by the Heart Failure Society of America. Circulation. 2001;104(24):2996-3007.
Aronow WS. Epidemiology, pathophysiology, prognosis, and treatment of systolic and dias- tolic heart failure in elderly patients. Heart Dis. 2003;5(4):279-94.
Carrara D. Avaliação prospectiva da qualidade de vida em pacientes com miocardiopatia dilatada submetidos a ventriculectomia parcial esquerda [dissertation]. São Paulo: Facul- dade de Medicina da Universidade de São Paulo; 2001.
Cline CM, Willenheimer RB, Erhardt LR, Wiklund I, Israelsson BY. Health-related quality of life in elderly patients with heart failure. Scand Cardiovasc J. 1999;33(5):278-85.
Santos SCM. Insuficiência cardíaca no idoso [Heart failure in the elderly]. Rev Soc Cardiol Estado de São Paulo. 2000;10(1):142-52. Available from: http://www.socesp.org.br/revis- tasocesp/edicoes/volume10/pdf/n01.pdf. Accessed in 2010 (Jul 23).
Trentini CM, Chachamovich E, Fleck MPA. Qualidade de vida em idosos. In: Fleck MPA. A avaliação de qualidade de vida: guia para profissionais da saúde. Porto Alegre: Artmed; 2008. p. 218-28.
Ciconelli RM. Medidas de avaliação de qualidade de vida [Measures of evaluation of quality of life]. Rev Bras Reumatol. 2003;43(2):IX-XIII.
Fleck MP, Chachamovich E, Trentini CM. Projeto WHOQOL-OLD: método e resultados de gru- pos focais no Brasil [WHOQOL-OLD Project: method and focus group results in Brazil]. Rev Saude Publica. 2003;37(6):793-9.
Saccomann IC, Cintra FA, Gallani MC. Psychometric properties of the Minnesota Living with Heart Failure--Brazilian version--in the elderly. Qual Life Res. 2007;16(6):997-1005.
Johansson P, Agnebrink M, Dahlström U, Broström A. Measurement of health-related quality of life in chronic heart failure, from a nursing perspective-a review of the literature. Eur J Cardiovasc Nurs. 2004;3(1):7-20.
Mitani H, Hashimoto H, Isshiki T, et al. Health-related quality of life of Japanese patients with chronic heart failure: assessment using the Medical Outcome Study Short Form 36. Circ J. 2003;67(3):215-20.
Bayliss EA, Bayliss MS, Ware JE Jr, Steiner JF. Predicting declines in physical function in per- sons with multiple chronic medical conditions: what we can learn from the medical problem list. Health Qual Life Outcomes. 2004;2:47.
Uemura K. International trends in cardiovascular diseases in the elderly. Eur Heart J. 1988;9 Suppl D:1-8.
Ciconelli RM. Tradução para o português e validação do questionário genérico de avaliação de qualidade de vida “medical outcomes study 36-item short-form health survey” (SF-36) [thesis]. São Paulo: Escola Paulista de Medicina da Universidade Federal de São Paulo; 1997.
Lobiondo-Wood G, Haber J. Nursing research: methods, critical appraisal and utilization. 3rd ed. St Louis: Mosby; Year-Book, 1994.
Jenkinson C, Jenkinson D, Shepperd S, Layte R, Petersen S. Evaluation of treatment for con- gestive heart failure in patients aged 60 years and older using generic measures of health status (SF-36 and COOP charts). Age Ageing. 1997;26(1):7-13.
Ekman I, Fagerberg B, Lundman B. Health-related quality of life and sense of coherence among elderly patients with severe chronic heart failure in comparison with healthy controls. Heart Lung. 2002;31(2):94-101.
Hayes V, Morris J, Wolfe C, Morgan M. The SF-36 health survey questionnaire: is it suitable for use with older adults? Age Ageing. 1995;24(2):120-5.
Cruz KCT, Diogo MJDE. Avaliação da capacidade funcional em idosos com Acidente Vascular Encefálico [Evaluation the quality of life in elderly with stroke: a exploratory and transversal study]. Online Braz J Nurs (Online). 2008;7(1).
Soares DA, Toledo JAS, Santos LF, Lima RMB, Galdeano LE. Qualidade de vida de porta- dores de insuficiência cardíaca [Quality of life of heart failure patients]. Acta Paul Enferm. 2008;21(2):243-8.
Souza FF. Avaliação de qualidade de vida do idoso em hemodiálise: comparação de dois instrumentos genéricos [dissertation]. Campinas: Faculdade de Ciências Médicas da Uni- versidade Estadual de Campinas; 2004.
Middel B, Bouma J, de Jongste M, et al. Psychometric properties of the Minnesota Living with Heart Failure Questionnaire (MLHF-Q). Clin Rehabil. 2001;15(5):489-500.
McHorney CA, Ware JE Jr, Lu JF, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care. 1994;32(1):40-66.
Lima MG, Barros MB, César CL, et al. Qualidade de vida relacionada à saúde em idosos, avaliada com o uso do SF-36 em estudo de base populacional [Health related quality of life among the elderly: a population-based study using SF-36 survey]. Cad Saude Publica. 2009;25(10):2159-67.
Franzén K, Blomqvist K, Saveman BI. Impact of chronic heart failure on elderly persons’ daily life: a validation study. Eur J Cardiovasc Nurs. 2006;5(2):137-45.
Pinheiro DPN. A resiliência em discussão [Resilience in discussion]. Psicol Estud. 2004;9(1):67-75.
Witham MD, Crighton LJ, McMurdo ME. Using an individualised quality of life measure in older heart failure patients. Int J Cardiol. 2007;116(1):40-5.
Brazier JE, Walters SJ, Nicholl JP, Kohler B. Using the SF-36 and Euroqol on an elderly popu- lation. Qual Life Res. 1996;5(2):195-204.
