The Impact of Heart Failure on Quality of Life: A Mixed Method Study

Abstract Introduction Heart failure (HF) is a significant global health problem, affecting over 64,000 people annually and resulting in high mortality rates (Savarese et al., 2023). However, for those receiving follow–up care, there is a 20% increase in 5–year survival (Braunwald, 2013). Globally, heart failure affects 1–3% of the population in developed countries, with 15 million patients in Europe and a 2% prevalence in Italy, accompanied by a 20% mortality rate (Heidenreich et al., 2022). Patients with heart failure often experience a reduction in quality of life (QoL), impacting their psychosocial well–being (Lupón, 2013). Indeed, those with lower QoL tend to experience more adverse events, such as rehospitalization and mortality (Ly et al., 2023). Therefore, it becomes crucial to assess QoL over time, utilizing new technologies for home monitoring. Continuous evaluation of QoL and the use of home monitoring technologies, such as telemedicine and telemonitoring, are essential and can have a positive impact on promoting QoL (Morken et al., 2022). OBJECTIVE: Investigate the perceived quality of life in geriatric patients with heart failure, describing the impact of the condition on QoL. Materials and Methods This mixed–methods study aims to explore QoL perception in a cohort of real–life outpatient geriatric patients with HF based on different stages of the disease. The study consists of two phases: a quantitative survey and a qualitative investigation. The KCCQ 23 scale was used to quantitatively assess self–reported QoL during in–person follow–up appointments and subsequently through phone follow–ups at 6 and/or 12 months. Additionally, the qualitative phase involved conducting semi–structured interviews via video calls. Results, Discussion and Conclusions The study involved 478 patients with heart failure, with women, who were underrepresented, reporting lower QoL than men. Analysis of interviews and subsequent triangulation of quantitative and qualitative data revealed that the QoL of HF patients is influenced by six identified themes: future perspectives, self–care, social interactions, emotional state, functional status, awareness of the disease, and awareness of one‘s health status. Furthermore, it was observed that deceased patients who received follow–up care reported significantly worse QoL scores compared to those who did not receive follow–up.