Article

Journal of Behavioral Medicine

, Volume 34, Issue 1, pp 13-22

Predictors of readmission and health related quality of life in patients with chronic heart failure: a comparison of different psychosocial aspects

  • Andreas VolzAffiliated withDivision of Social and Behavioral Health Research, Institute of Social and Preventive Medicine (ISPM), University of Bern
  • , Jean-Paul SchmidAffiliated withCardiovascular Prevention and Rehabilitation, Swiss Cardiovascular Center Bern, Bern University Hospital, University of Bern
  • , Marcel ZwahlenAffiliated withInstitute of Social and Preventive Medicine (ISPM), University of Bern
  • , Sonja KohlsAffiliated withCardiovascular Prevention and Rehabilitation, Swiss Cardiovascular Center Bern, Bern University Hospital, University of Bern
  • , Hugo SanerAffiliated withCardiovascular Prevention and Rehabilitation, Swiss Cardiovascular Center Bern, Bern University Hospital, University of Bern
  • , Jürgen BarthAffiliated withDivision of Social and Behavioral Health Research, Institute of Social and Preventive Medicine (ISPM), University of Bern Email author 

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Abstract

Psychological distress is common in patients with chronic heart failure. The impact of different psychological variables on prognosis has been shown but the comparative effects of these variables remain unclear. This study examines the impact of depression, anxiety, vital exhaustion, Type D personality, and social support on prognosis in chronic heart failure patients. One hundred eleven patients (mean age 57 ± 14 years) having participated in an exercise based ambulatory cardiac rehabilitation program were enrolled in a prospective cohort study. Psychological baseline data were assessed at program entry. Mortality, readmission, and health-related quality of life were assessed at follow up (mean 2.8 ± 1.1 years). After controlling for disease severity none of the psychological variables were associated with mortality, though severe anxiety predicted readmission [HR = 3.21 (95% CI, 1.04–9.93; P = .042)]. Health-related quality of life was independently explained by vital exhaustion, anxiety and either body mass index (physical dimension) or sex (emotional dimension). As psychological variables have a strong impact on health-related quality of life they should be routinely assessed in chronic heart failure patients` treatment.

Keywords

Psychological stress Depression Anxiety Heart failure Mortality Quality of life