Key result
Physical symptoms explain ~40% of quality of life variance, largely mediating heart failure symptom impacts.
Why the study?
To determine how different symptoms contribute to quality of life and evaluate the mediating role of psychological and physical symptoms in patients with chronic heart failure.
Cross-Sectional (n=2,006)
Yes
In patients with chronic heart failure, physiological and psychological symptoms mediate the majority of the negative impact that heart failure symptoms have on quality of life, highlighting the need for comprehensive symptom management.
Supports integrated symptom assessment in chronic HF; hypothesis-generating for mediator-targeted interventions in prospective studies.
AIMS: To determine the contributions of different kinds of symptoms to the quality of life and mediating effect of psychological and physical symptoms between heart failure symptoms and quality of life. DESIGN: A multi-centre cross-sectional study. METHODS: 2006 chronic heart failure patients from four cities were recruited in China from January 2021 to December 2022. Patients' symptoms and quality of life were self-reported, and data were analysed using correlation analysis, dominance analysis and mediating effects analysis. RESULTS: The dominance analysis revealed that the overall mean contributions of heart failure, psychological and physical symptoms were .083, .085 and .111; 29.5%, 30.2% and 39.5% of the known variance. And heart failure symptoms could negatively affect quality of life through psychological and physical symptoms, accounting for 28.39% and 22.95% of the total effect. Heart failure symptoms could also affect quality of life through the chain-mediated effect of physical and psychological symptoms, accounting for 16.74%. CONCLUSIONS: Physiological symptoms had the strongest effect on quality of life and heart failure symptoms had the weakest. Most of the effect for heart failure symptoms on quality of life in chronic heart failure patients was mediated by psychological and physiological symptoms. RELEVANCE TO CLINICAL PRACTICE: It is important to design non-pharmacological intervention plans for the enhancement of physical and psychological symptoms' management skills, to reduce the adverse impact of heart failure symptoms on quality of life. REPORTING METHOD: Study methods and results reported in adherence to the STROBE checklist. NO PATIENT OR PUBLIC CONTRIBUTION: No patients or members of the public were involved in the study.
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Wang et al. (2023) conducted a cross-sectional in chronic heart failure (n=2,006). Heart failure symptoms was evaluated on Quality of life. Physical symptoms contributed most to quality of life variance (39.5%), while the effect of heart failure symptoms (29.5%) was largely mediated by psychological and physical symptoms.
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