The impact of heart failure on mental health and health-related quality of life in Ethiopia: a mixed-methods study

Teshome, Henok Mulugeta

The impact of heart failure on mental health and health-related quality of life in Ethiopia: a mixed-methods study

Teshome, Henok Mulugeta

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Publication Type:: Thesis
Issue Date:: 2024

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Field	Value	Language
dc.contributor.author	Teshome, Henok Mulugeta
dc.date.accessioned	2025-05-22T03:48:51Z
dc.date.available	2025-05-22T03:48:51Z
dc.date.issued	2024
dc.identifier.uri	http://hdl.handle.net/10453/187458
dc.description	University of Technology Sydney. Faculty of Health.	en_US.UTF-8
dc.description.abstract	Background: Globally, heart failure is associated with a high morbidity and mortality rate and can affect the physical, emotional, and social functioning of affected populations. This study aimed to assess the impact of heart failure on mental health and health-related quality of life in Ethiopian adults. Methods: This study consisted of three phases. Phase I involved two systematic reviews. Phase II and III used a sequential explanatory mixed-methods design, starting with a quantitative cross-sectional study, followed by a qualitative descriptive study. The revised Wilson and Cleary model of quality of life and the Theory of Symptom Management were used to guide this research. Participants attending a cardiac outpatient clinic at two tertiary-level public hospitals in Addis Ababa, Ethiopia, were invited to participate in the study. Quantitative data were analysed using descriptive analyses and regression models, while qualitative data were analysed using thematic analysis. The quantitative and qualitative findings were integrated. Results: Two systematic reviews examined depression and health-related quality of life in people living with heart failure in low-middle-income countries. The first review, comprising 21 studies (N = 5,074), reported a pooled depression prevalence of 51.5%. The second review, which included 33 studies (N= 5,612), reported poor health-related quality of life in people with heart failure. The cross-sectional study (N=383) showed a mean Patient Health Questionnaire-9 score of 11.02±6.14, with 56.6% of participants having depression. The mean Minnesota Living with Heart Failure Questionnaire score was 48.03±19.73, and 54% of participants had poor health-related quality of life. Age, diabetes mellitus comorbidity, and depression were associated with worse health-related quality of life, while higher social support was linked to better health-related quality of life. Six themes were identified in the qualitative phase: Journey from diagnosis to daily life with heart failure, Symptom experiences, Impact of heart failure on health-related quality of life, Perception of health-related quality of life, Symptom management and coping strategies, and Challenges faced in the journey of living with heart failure. Conclusions: This study revealed a high prevalence of depression and poor health-related quality of life in Ethiopian people with heart failure. The impact of heart failure on various aspects of their lives, combined with their poor health perceptions, significantly affects their health-related quality of life. The findings have implications for nursing practice and the care of people with heart failure in Ethiopia. Strategies to assist healthcare professionals in identifying, managing, and delivering appropriate psychosocial interventions are early recommended.	en_US.UTF-8
dc.format	Thesis (PhD)
dc.language.iso	en_US	en_US.UTF-8
dc.relation	https://opus.lib.uts.edu.au/bitstream/10453/187458/1/thesis.pdf
dc.rights	info:eu-repo/semantics/openAccess
dc.rights	The author owns the copyright in this thesis including all reproduction and reuse rights for the work. The work may not be altered without the permission of the copyright owner. Attribution is essential when quoting or paraphrasing from this thesis.
dc.rights	© 2024 Henok Mulugeta Teshome
dc.rights	au.edu.uts.lib/cph
dc.title	The impact of heart failure on mental health and health-related quality of life in Ethiopia: a mixed-methods study	en_US.UTF-8
dc.type	Thesis
utslib.copyright.status	open_access	*

Abstract:

Background: Globally, heart failure is associated with a high morbidity and mortality rate and can affect the physical, emotional, and social functioning of affected populations. This study aimed to assess the impact of heart failure on mental health and health-related quality of life in Ethiopian adults. Methods: This study consisted of three phases. Phase I involved two systematic reviews. Phase II and III used a sequential explanatory mixed-methods design, starting with a quantitative cross-sectional study, followed by a qualitative descriptive study. The revised Wilson and Cleary model of quality of life and the Theory of Symptom Management were used to guide this research. Participants attending a cardiac outpatient clinic at two tertiary-level public hospitals in Addis Ababa, Ethiopia, were invited to participate in the study. Quantitative data were analysed using descriptive analyses and regression models, while qualitative data were analysed using thematic analysis. The quantitative and qualitative findings were integrated. Results: Two systematic reviews examined depression and health-related quality of life in people living with heart failure in low-middle-income countries. The first review, comprising 21 studies (N = 5,074), reported a pooled depression prevalence of 51.5%. The second review, which included 33 studies (N= 5,612), reported poor health-related quality of life in people with heart failure. The cross-sectional study (N=383) showed a mean Patient Health Questionnaire-9 score of 11.02±6.14, with 56.6% of participants having depression. The mean Minnesota Living with Heart Failure Questionnaire score was 48.03±19.73, and 54% of participants had poor health-related quality of life. Age, diabetes mellitus comorbidity, and depression were associated with worse health-related quality of life, while higher social support was linked to better health-related quality of life. Six themes were identified in the qualitative phase: Journey from diagnosis to daily life with heart failure, Symptom experiences, Impact of heart failure on health-related quality of life, Perception of health-related quality of life, Symptom management and coping strategies, and Challenges faced in the journey of living with heart failure. Conclusions: This study revealed a high prevalence of depression and poor health-related quality of life in Ethiopian people with heart failure. The impact of heart failure on various aspects of their lives, combined with their poor health perceptions, significantly affects their health-related quality of life. The findings have implications for nursing practice and the care of people with heart failure in Ethiopia. Strategies to assist healthcare professionals in identifying, managing, and delivering appropriate psychosocial interventions are early recommended.

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