Avaliação do estado de saúde percebido e do impacto da insuficiência cardíaca por pacientes em seguimento ambulatorial / Assessment of the perceived health condition and the impact of heart failure by outpatients

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

Heart Failure (HF) is a chronic and debilitating condition of high morbidity and mortality that provokes changes in the health related quality of life (HRQL). A descriptive, correlational study type transversal cut with 138 outpatients with HF was performed with the objectives of assessing the general health condition by Medical Outcomes Survey 36 - Item Short-Form (SF-36), the impact of HF in daily life using the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and analyzing the relations between these two variables and the perceived health condition and the impact of HF with socio-demographic and clinical variables. The data were collected through interviews and, subsequently, processed and analyzed by descriptive statistics, test on Pearsons correlation, t-test and ANOVA for comparison among the groups and analyses of internal consistency of the used instruments (Cronbachs ). The level of significance was 0,05. It was found that the most patients were men, average age 56 years old, married, low rate of literacy and retired with two minimum wages as individual monthly minimum revenue. Clinically, they presented HF secondary to Idiopathic Dilated myocardiopathy followed by Chagasmyocardiopathy with functional class (CF-NYHA) II and III, serious systolic dysfunction, in other words, decreased value of left ventricular ejection fraction (LVEF) and with other related diseases. The instruments presented, mostly, satisfactory internal consistency (0,44 to 0,88 for SF-36 and 0,78 to 0,93 for the total MLHFQ and its dimensions). The assessment of the values of SF-36 may vary from zero to 100 with increased values indicating better perceived health condition and the MLHFQ assessment varies from zero to 105 with increased values indicating greater impact on daily patients life. The results were presented in means and standard deviation. The most impaired components of SF-36 were the physical (36,8+41,2) and emotional (47,6+43,9) aspects. The MLHFQ achieved the value 35,8 (+24,9) for the total; 13,6 (+11,5) for the physical dimension and 8,3 (+6,7) for the emotional dimension. The correlation among instruments had a strong importance and all were statistically significant. The impact of HF on womens lives (41,2+24,3) was more severe than on mens (32,2+24,9). The correlation among the MLHFQ, the age and time in an outpatient clinic was presented as negative and weak, but statistically significant only for the time. The total and clinical variables correlations of MLHFQ were statistically significant. The impact of HF tends to increase with decreased LVEF and increased CF-NYHA. The general perceived health condition and the impact of HF on daily life were reasonably impaired. The more the perception on the general health condition the more the patients with HF feel the impact of this chronic health condition on their daily life. It is more common in young women patients with decreased time in outpatient clinic and whose condition was more severe related to the systolic dysfunction and to the symptoms. These patients need greater attention from the health team during the outpatient clinical care, especially in the onset of the medical assistance.

ASSUNTO(S)

impact of the disease on quality of life congestive heart failure quality of life insuficiência cardíaca congestiva impacto da doença na qualidade de vida qualidade de vida

ACESSO AO ARTIGO

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