Care dependency and associated clinical factors in patients with pulmonary hypertension: a cross-sectional study

Pulmonary hypertension (PH) is a progressive condition that may impair daily functioning and increase care needs. However, data on care dependency in patients with PH remain limited. This study aimed to determine the level of care dependency in patients with PH and to identify factors associated with greater dependency. This descriptive, correlational, cross-sectional study included 85 adults with Pulmonary Arterial Hypertension (PAH) or Chronic Thromboembolic Pulmonary Hypertension (CTEPH) followed at PH outpatient clinic between March 2023 and April 2024. Data were collected using the Individual Identification Form, Care Dependency Scale (CDS), and Pulmonary Arterial Hypertension Symptom Scale (PAHSS). Group comparisons, correlation analyses, and hierarchical multiple linear regression were performed. The mean age was 54.47 ± 16.76 years, and 83.5% of participants were women. The mean CDS score was 61.69 ± 16.71, indicating generally low care dependency. Higher dependency was observed in patients with lower educational and income levels, unemployment, non-spousal living arrangements, hospitalization in the previous year, symptom exacerbation, World Health Organization (WHO) functional class, and comorbid cardiovascular disease or diabetes ( p < 0.05). Care dependency was significantly associated with greater symptom burden and worse functional status. In hierarchical regression analysis, sociodemographic variables explained 34.8% of the variance in CDS scores, and clinical variables explained an additional 38.4% (ΔR²=0.384, p < 0.001). Symptom severity (β=−0.426), WHO functional class (β=−0.235), diabetes mellitus (β=−0.152) and education level (β = 0.170) were independently associated with care dependency (adjusted R²=0.704, p < 0.001). Although overall care dependency was low, patients with greater symptom burden, worse functional class and diabetes were more likely to experience higher dependency, independent of sociodemographic characteristics. Because these simple, routinely collected variables explained a large proportion of the variance, they may help to identify quickly the patients who would benefit from targeted nursing interventions, symptom management and individualized support in PH outpatient care. Not applicable.