Uncertainty as a Barrier to Self-Care and Quality of Life in Patients With Heart Failure With Reduced Ejection Fraction.

Abstract

Background and Purpose: Quality of life (QoL) and self-care behaviors (SCB) are crucial for patients with heart failure, yet the uncertainty surrounding health outcomes can severely undermine these aspects, particularly in patients with heart failure with reduced ejection fraction (HFrEF). This study aimed to determine the collective impact of perceived uncertainty on both QoL and SCB in HFrEF patients. Methods: A cross-sectional study was conducted among 118 HFrEF patients recruited from cardiology clinics. Data were collected using the Mishel Uncertainty in Illness Scale-Community Form, the Left Ventricular Dysfunction Scale, and the European Heart Failure Self-Care Behavior Scale. The primary analysis, a one-way multivariate analysis of variance (MANOVA), assessed the relationship between uncertainty and the combined outcomes of QoL and SCB. Additional analyses, including a two-way MANOVA and multiple regression, examined predictors such as age, gender, body mass index, and New York Heart Association (NYHA) class. Results: Of the participants, 62.7% reported low uncertainty. Higher levels of uncertainty significantly predicted lower QoL and SCB scores (F = 15.795, p < .001, η² = .216). Other significant predictors included age, gender, body mass index, duration since diagnosis, and NYHA class. Implications for Practice: These findings highlight the pressing need for health care professionals to address uncertainty in HFrEF patients through tailored interventions. Reducing uncertainty can enhance both QoL and SCB, empowering patients to manage their condition more effectively. Future research should develop and evaluate interventions that reduce uncertainty, thereby fostering improved patient engagement, resilience, and long-term well-being.