The Study On Quality Of Life And Disease Management Among Patients With Chronic Heart Failure Dwelling In Community And Their Family Caregivers

Objective To investigate the quality of life and the disease management among patients with chronic heart failure dwelling in community and their family caregivers and to explore its influencing factors, and to examine the relationship between disease management and quality of life of patients and their caregivers.Methods A sample of155patients with heart failure dwelling in community and their family caregivers were recruited by non-probability sampling method. All patients had been hospitalized in the cardiovascular departments and CCU of three tertiary hospital in Nantong city, Jiangsu Province during the period of January2008to August2011. The data of patients was collected by the general information, Atlanta Heart Failure Knowledge Test-V2(AHFKT-V2), the European Heart Failure Self-care Behavior Scale (EHFScBS), Minnesota heart failure quality of life scale (LHFQ) and chronic disease self-efficacy scale. The family caregiver’s data was collected by the general information questionnaire, Atlanta Heart Failure Knowledge Test-V2(AHFKT-V2), Heart Failure Family caregivers disease management questionnaire, Family Caregiver-Specific Quality of Life Scale (FAMQOL) and general self-efficacy scale.Results1) The average score of disease knowledge of the CHF patients was17.36(with a standard deviation of4.21) and their family caregivers was17.66(with a standard deviation of3.98). There was a significantly positive correlation between the knowledge level of patients and their family caregivers. Dimension rank of knowledge score from low to high was taking medicine, pathology, behavior, diet and symptom management.2) The average score of EHFScBS of the patients was36.96(with a standard deviation of8.85),and the average score of family caregivers’ disease management behavior was55.26(with a standard deviation of15.38). There was a significant correlation between the behavior of the patients and their family caregivers (P<0.01); Multiple regression showed that caregiver’s disease management behavior, the patient’s knowledge, economic condition had independent effects on the patient’s self-care behavior (R2=0.39, F=32.07, P<0.01);and patients self-care behavior, caregiver’s self-efficacy, caregiver’s knowledge also had independent effects on caregiver’s disease management behavior (R2=0.41, F=35.45, P<0.01).3) The average score of the patients’LHFQ was45.47, with a standard deviation of26.10. Dimension rank from low to high was somatic,other and mood dimension; The average score of the family caregivers’FAMQOL score was54.91, with a standard deviation of10.45, Dimension rank from low to high was psychological, physical, social and spiritual dimension. Multiple regression showed that patients’s cardiac function, self-efficacy, the QOL of caregivers, frequence of patient’s inhosiptalization and patient’s occupation had significant impact on the QOL of patients (R2=0.53, F=33.24, P<0.01); the QOL of Patients, caregiver’s self-efficacy, patient’s cardiac function, caregiver’s education degree had significant impact on the QOL of family caregivers (R2=0.34, F=15.31, P<0.01).Conclusion The disease knowledge of Chronic heart failure patients and family caregivers are poor, they have yet to be improved. The disease management of chronic heart failure patients are not good as well as their family caregivers,, especially in taking flu vaccinations and monitoring fluid retention. Patients’ behavior interact with their family caregivers’s behavior. Knowledge of heart failure has a serious effect on the family disease management. The quality of life of patients and family caregivers are both damaged. Patient’s cardiac function is the most important influencing factor of the patient’s quality of, life as well as their family cargivers. Self-efficacy of patients and caregivers have separate effects on their quality of life. Patient’s self-care is an important predictor in somatic health of the patients. It is imperative to establish family-centered recovery/secondary prevention system to improve disease control and the quality of life of paitents and their family caregivers.