心臟衰竭病人之生活品質及其相關因素

Quality of Life and Associated Factors in Patients With Heart Failure

背景：心臟衰竭為一種慢性且會漸進惡化的疾病，常會大大地降低病患之生活品質，而臨床上主要仍是偏重於疾病之身體症狀的治療，但是對生活品質之相關因素的研究仍有限。
目的：探討心臟衰竭病人之生活品質及其相關因素。
方法：採橫斷式、相關性研究設計，以症狀量表、功能狀態量表、憂鬱量表及生活品質量表等結構式問卷收集資料；立意取樣年滿二十歲且診斷為心臟衰竭之患者，於南部某醫學中心及區域教學醫院之心臟血管內科病房及門診收案共200人；所得資料以SPSS 14.0套裝軟體進行統計分析。
結果：(1)研究對象生活品質指標得分為63.0，屬中等程度；(2)婚姻狀況、目前有無職業、家庭月收入、合併有糖尿病或高血壓、合併疾病數目、有無服藥、是否注射藥物及氧氣使用與否在生活品質上達顯著性差異；(3)症狀指標得分為54.1，屬中等程度，與生活品質達顯著性正相關；(4)功能狀態以紐約心臟學會功能分級第II級者最多，憂鬱平均得分為9.13 ± 6.25，屬正常範圍，但17.5%有憂鬱情形；此二變項與生活品質均達顯著性負相關；(5)憂鬱、症狀及家庭月收入為生活品質之重要預測因子，可解釋59.3%之總變異量。
應用本研究結果可提供心臟衰竭病人之生活品質及其相關影響因素的實證性資料，作為健康專業人員適切性的評估與照護之參考依據，以改善心臟衰竭病人之症狀、功能狀態及憂鬱情形，進而增進其生活品質。

Background: Heart failure is a chronic and exacerbating disease, which often significantly decreases patient quality of life (QOL). Treatments continue to focus on alleviating the physical symptoms of this disease, and data on QOL factors are limited.
Purpose: The purpose of this study was to explore QOL and associated factors in patients with heart failure.
Methods: A cross-sectional and correlational research design was conducted using the Kansas City Cardiomyopathy Questionnaire, Beck Depression Inventory-II, and the World Health Organization Quality of Life Assessment. A convenience sample of 200 patients aged 20 years old or above and diagnosed with heart failure were recruited from one medical center and one regional teaching hospital in southern Taiwan. Data were analyzed using SPSS 14.0 software.
Results: Results found (1) participants had an average QOL index score of 63.0 (moderate); (2) significant differences in QOL scores for the variables of marriage, occupation type, monthly family income, concomitant diabetes / hypertension, number of complications, and treatment type; (3) participants had an average index score for symptoms of 54.1 (moderate) that was significantly correlated with QOL; (4) a majority of participants were classified in NYHA Class II, mean score of depression was 9.13 ± 6.25 (normal), and functional status and depression were significantly related to QOL; and (5) 59.3% of QOL variance was explained by depression, symptoms and family income per month.
Conclusions: This study may help health professionals to understand relationships among symptoms, functional status, depression and QOL in heart failure patients. It may also provide healthcare professionals evidence-based data necessary to further improve symptoms, functional status and depression in heart failure patients, and thus significantly improve QOL in patients with heart failure.