TY - JOUR
T1 - An international comparison of factors affecting quality of life among patients with congestive heart failure
T2 - A cross-sectional study
AU - Roy, Brita
AU - Wolf, Judith R.L.M.
AU - Carlson, Michelle D.
AU - Akkermans, Reinier
AU - Bart, Bradley
AU - Batalden, Paul
AU - Johnson, Julie K.
AU - Wollersheim, Hub
AU - Hesselink, Gijs
N1 - Publisher Copyright:
© 2020 This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.
PY - 2020/4
Y1 - 2020/4
N2 - Objective To explore associations among twenty formal and informal, societal and individual-level factors and quality of life (QOL) among people living with congestive heart failure (CHF) in two settings with different healthcare and social care systems and sociocultural contexts. Setting and participants We recruited 367 adult patients with CHF from a single heart failure clinic within two countries with different national social to healthcare spending ratios: Minneapolis, Minnesota, United States (US), and Nijmegen, Netherlands (NL). Design Cross-sectional survey study. We adapted the Social Quality Model (SQM) to organize twenty diverse factors into four categories: Living Conditions (formal-societal: E.g., housing, education), Social Embeddedness (informal-societal: E.g., social support, trust), Societal Embeddedness (formal-individual: E.g., access to care, legal aid), and Self-Regulation (informal-individual: E.g., physical health, resilience). We developed a survey comprising validated instruments to assess each factor. We administered the survey in-person or by mail between March 2017 and August 2018. Outcomes We used Cantril's Self-Anchoring Scale to assess overall QOL. We used backwards stepwise regression to identify factors within each SQM category that were independently associated with QOL among US and NL participants (p<0.05). We then identified factors independently associated with QOL across all categories (p<0.05). Results 367 CHF patients from the US (32%) and NL (68%) participated. Among US participants, financial status, receiving legal aid or housing assistance, and resilience were associated with QOL, and together explained 49% of the variance in QOL; among NL participants, financial status, perceived physical health, independence in activities of daily living, and resilience were associated with QOL, and explained 53% of the variance in QOL. Conclusions Four formal and informal factors explained approximately half of the variance in QOL among patients with CHF in the US and NL.
AB - Objective To explore associations among twenty formal and informal, societal and individual-level factors and quality of life (QOL) among people living with congestive heart failure (CHF) in two settings with different healthcare and social care systems and sociocultural contexts. Setting and participants We recruited 367 adult patients with CHF from a single heart failure clinic within two countries with different national social to healthcare spending ratios: Minneapolis, Minnesota, United States (US), and Nijmegen, Netherlands (NL). Design Cross-sectional survey study. We adapted the Social Quality Model (SQM) to organize twenty diverse factors into four categories: Living Conditions (formal-societal: E.g., housing, education), Social Embeddedness (informal-societal: E.g., social support, trust), Societal Embeddedness (formal-individual: E.g., access to care, legal aid), and Self-Regulation (informal-individual: E.g., physical health, resilience). We developed a survey comprising validated instruments to assess each factor. We administered the survey in-person or by mail between March 2017 and August 2018. Outcomes We used Cantril's Self-Anchoring Scale to assess overall QOL. We used backwards stepwise regression to identify factors within each SQM category that were independently associated with QOL among US and NL participants (p<0.05). We then identified factors independently associated with QOL across all categories (p<0.05). Results 367 CHF patients from the US (32%) and NL (68%) participated. Among US participants, financial status, receiving legal aid or housing assistance, and resilience were associated with QOL, and together explained 49% of the variance in QOL; among NL participants, financial status, perceived physical health, independence in activities of daily living, and resilience were associated with QOL, and explained 53% of the variance in QOL. Conclusions Four formal and informal factors explained approximately half of the variance in QOL among patients with CHF in the US and NL.
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U2 - 10.1371/journal.pone.0231346
DO - 10.1371/journal.pone.0231346
M3 - Article
C2 - 32267902
AN - SCOPUS:85083072327
SN - 1932-6203
VL - 15
JO - PloS one
JF - PloS one
IS - 4
M1 - e0231346
ER -