Associations between disease severity, coping and dimensions of health-related quality of life in patients admitted for elective coronary angiography - a cross sectional study

Bjørg Ulvik, Ottar Nygård, Berit R Hanestad, Tore Wentzel-Larsen, Astrid K Wahl, Bjørg Ulvik, Ottar Nygård, Berit R Hanestad, Tore Wentzel-Larsen, Astrid K Wahl

Abstract

Background: In patients with suspected coronary artery disease (CAD), the overall aim was to analyse the relationships between disease severity and both mental and physical dimensions of health related quality of life (HRQOL) using a modified version of the Wilson and Cleary model.

Methods: Using a cross-sectional design, 753 patients (74% men), mean age 62 years, referred for elective cardiac catheterisation were included. The measures included 1) physiological factors 2) symptoms (disease severity, self-reported symptoms, anxiety and depression 3) self-reported functional status, 4) coping, 5) perceived disease burden, 6) general health perception and 7) overall quality of life. To analyse relationships, we performed linear and ordinal logistic regressions.

Results: CAD and left ventricular ejection fraction (LVEF) were significantly associated with symptoms of angina pectoris and dyspnea. CAD was not related to symptoms of anxiety and depression, but less depression was found in patients with low LVEF. Angina pectoris and dyspnea were both associated with impaired physical function, and dyspnea was also negatively related to social function. Overall, less perceived burden and better overall QOL were observed in patients using more confronting coping strategy.

Conclusion: The present study demonstrated that data from cardiac patients to a large extent support the suggested model by Wilson and Cleary.

Figures

Figure 1
Figure 1
A modified version of the Wilson & Cleary model. LVEF: Left ventricular ejection fraction; AFS: Angina Frequency Scale; CCS: Canadian Cardiovascular Society classification; NYHA: New York Heart Association; HADS: Hospital Anxiety and Depression Scale; ECS: Exertional Capacity Scale; SF: Social Function; Coping: Confrontive coping, Normalising Optimistic Coping, Combined Emotive coping; Burden: Perception of living with angina pectoris.
Figure 2
Figure 2
A: Association between left ventricular ejection fraction and angina (Angina Frequency Scale). B: Association between left ventricular ejection fraction and depression (HADS).

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