Health-related quality of life in patients with myocardial infarction : trends and predictors
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Helping people to “live longer and live better” is the principal goal of healthcare systems, that is, to enhance both survival and health status. As the survival of patients with myocardial infarction (MI) increases with effective and timely therapy, attentions turn to improving patients’ health status, recovery and quality of life. Health-related quality of life (HRQoL) consists of broad constructs that cover various aspects of patient life. Cardiac events, including MI often have negative effects on HRQoL, which is an important measure, independently predicting mortality and future cardiac events in patients with MI. It is also used as an indicator of therapeutic response in these patients. Assessment and monitoring of cardiac patients’ health status including their HRQoL has been highly recommended as a key measure of cardiovascular health. The aim of this study was to examine the changes in HRQoL scores of patients over the acute phase of MI and determine significant predictors of HRQoL immediately after experience of MI (within a few days) and at three months after discharge from hospital. A longitudinal survey design was used. Participants were recruited from two tertiary hospitals in South Korea. A total of 150 study participants completed self-report questionnaires at baseline (within a few days after the experience of MI) and at the three-month follow-up (n=136). A Korean version of the MacNew Heart Disease Health-related Quality of Life Questionnaire (MacNew) was prepared, evaluated for construct validity and internal consistency, and used for assessing HRQoL. Health-related quality of life scores improved significantly at three months follow-up, compared to baseline. Using the backward elimination stepwise regression analysis, six variables—financial status, physical activity, diabetes, a history of stroke, history of heart disease, and the DASS score—were significantly correlated with HRQoL of the patients at baseline. The significant predictors of HRQoL at the three-month follow-up, included age, gender, education level, self-assessed financial situation, diagnosis, left ventricular ejection fraction (LVEF), depression, anxiety, stress, illness perception, and social support. The findings of this study can help identify patients who are likely to experience diminished HRQoL after MI. Early psychological and social support may reduce the influence of MI on patients’ function and health status outcomes. While some factors cannot be modified or are difficult to amend, targeting the modifiable factors through psychosocial support, financial support, and improving patients’ understanding of their disease and recovery process may have the capacity to improve their HRQoL and enhance clinical care.
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