Predictors of quality of life after cardiac procedures: a mixed-methods study.

IF 3.4 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Niki Medendorp, Hilda Rijnhart-de Jong, Ilse Verstraaten, Tom Oirbans, Edgar Daeter, Henrico Wesselink, Roel Snijder, Daniela Schulz, Pepijn van der Voort, Christiaan Boerma, Dennis Duiker, Anja Machielse, Machteld Huber, Johanna Takkenberg, Dennis van Veghel
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Abstract

Purpose: Cardiovascular disease has a major impact on patients' lives. Cardiac procedures aim to improve patient health-related quality of life (HRQoL); however, some patients show little to no improvement afterwards. Changes in HRQoL are used to evaluate quality of care, and to enhance shared decision-making. We aimed to explore determinants predictive of HRQoL changes in patients undergoing a cardiac procedure.

Methods: A stepwise, mixed-methods study was conducted. First, relevant determinants were identified and selected by performing a literature search and Delphi study. Next, a cross-sectional survey study was conducted among patients who underwent a cardiac procedure. The impact of determinants on changes in HRQoL (measured with the SF36-2/SF12-2, or Effect On Quality-Of-Life Questionnaire (AFEQT)) was examined.

Results: Based on the literature search and Delphi study, 19 determinants were selected and subsequently observed among patients. In total, 1016 patients participated; 731 undergoing a CABG, PCI or SAVR (CPS-group), and 285 undergoing a PVI (PVI-group). In the CPS-group, 9 determinants were associated with significant changes in physical HRQoL and 9 determinants for mental HRQoL were found. In the PVI-group, significant determinants in the four AFEQT domains were found.

Conclusion: This study shows that several psychological and social factors are significant predictors for patients' HRQoL after cardiac procedures. Addressing these factors in consultations is considered important when deciding about cardiac procedures. This may allow shared decision making, enhance patient expectations and be beneficial for choosing the most optimal treatment choice for the individual patient.

心脏手术后生活质量的预测因素:一项混合方法研究。
目的:心血管疾病对患者的生活有重大影响。心脏手术旨在改善患者健康相关生活质量(HRQoL);然而,一些患者在术后几乎没有好转。HRQoL的变化用于评估护理质量,并加强共同决策。我们的目的是探讨心脏手术患者HRQoL变化的预测因素。方法:采用逐步、混合方法进行研究。首先,通过文献检索和德尔菲研究,确定并选择了相关的决定因素。接下来,在接受心脏手术的患者中进行了横断面调查研究。研究了决定因素对HRQoL变化的影响(用SF36-2/SF12-2或生活质量影响问卷(AFEQT)测量)。结果:在文献检索和德尔菲研究的基础上,选择了19个决定因素,并在患者中进行了观察。共有1016名患者参与;731例行CABG、PCI或SAVR (cps组),285例行PVI (PVI组)。在cps组中,9个决定因素与生理HRQoL的显著变化相关,9个决定因素与精神HRQoL的显著变化相关。在pvi组中,发现了四个AFEQT结构域的重要决定因素。结论:本研究表明,心理和社会因素是心脏手术后患者HRQoL的重要预测因素。在决定心脏手术时,在咨询中解决这些因素被认为是重要的。这可能允许共同决策,提高病人的期望,并有利于为个别病人选择最优的治疗方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Quality of Life Research
Quality of Life Research 医学-公共卫生、环境卫生与职业卫生
CiteScore
6.50
自引率
8.60%
发文量
224
审稿时长
3-8 weeks
期刊介绍: Quality of Life Research is an international, multidisciplinary journal devoted to the rapid communication of original research, theoretical articles and methodological reports related to the field of quality of life, in all the health sciences. The journal also offers editorials, literature, book and software reviews, correspondence and abstracts of conferences. Quality of life has become a prominent issue in biometry, philosophy, social science, clinical medicine, health services and outcomes research. The journal''s scope reflects the wide application of quality of life assessment and research in the biological and social sciences. All original work is subject to peer review for originality, scientific quality and relevance to a broad readership. This is an official journal of the International Society of Quality of Life Research.
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