Atrial fibrillation (AF) is a common cardiac arrhythmia associated with poor health-related quality of life (HRQoL). However, the factors influencing HRQoL in patients with AF are not well understood. The purpose of integrative review was to investigate the factors affecting HRQoL in patients with AF based on the six domains of Ferrans and colleagues’ HRQoL model. A total of 23 relevant articles published between January 2000 and March 2018 were identified using four databases and analyzed in this study. Our review showed that the HRQoL in patients with AF was consistently lower than both healthy individuals and patients with other cardiovascular diseases. The most common factor associated with HRQoL in patients with AF was anxiety-specific to AF in the symptoms domain, followed by frequency and severity of symptoms and the New York Heart Association functional class. This study highlights that monitoring and assessing patients’ symptoms is vital for improving HRQoL in patients with AF. Disease-specific and cross-culturally validated tools can allow healthcare professionals to provide tailored interventions for patients with AF.

Chronic kidney disease (CKD) is a progressive and lifelong condition with multiple medical comorbidities. Patients with CKD experience frailty more frequently and have lower health-related quality of life than do those with other chronic diseases. The purpose of this study was to examine the prevalence of frailty and investigate the contribution of frailty to quality of life in pre-dialysis CKD patients in Korea. Using a cross-sectional survey design, data were collected at an outpatient CKD clinic in a general hospital in Korea. The frailty criterion was modified from previous studies. The Short Form-36 Health Survey version 2 was used to measure physical and mental component summary scores. Data were analyzed using chi-square, t-tests, and hierarchical linear regression. Of the 168 CKD patients, 63 (37.5 %) were frail. Frail patients were significantly older and had lower physical and mental quality of life than those who were non-frail. In hierarchical regression evaluating the influence of frailty on physical and mental quality of life, the initial model was significantly improved when frailty was included. Frail patients had lower physical and mental quality of life. Frailty affected both physical and mental quality of life in pre-dialysis patients with CKD. More attention should be paid to the potential role of early detection and prevention of frailty to improve patients’ quality of life.

이숙정, et al. Korean J Adult Nurs. 2021 Aug;33(4):360-375. https://doi.org/10.7475/kjan.2021.33.4.360

Aim: This study was aimed at investigating the level of patient activation, and its association with self-care behaviours in older people with heart failure. Design: Cross-sectional secondary data analysis was conducted. Methods: We included a total of 182 Korean patients with heart failure who were aged >= 65 years for a cardiovascular outpatient clinic visit. Baseline characteristics, the Patient Activation Measure (PAM), health literacy, disease knowledge and self--care behaviours were collected via a self-administered questionnaire. Results: The proportion of patient activation at Levels 1 and 2 was 22.5% and 14.3%, respectively. Highly activated patients had a high level of health literacy, disease knowledge and self-care behaviours. After adjusting for confounding factors, we observed that patient activation was the only statiscally significant predictor of self-care behaviours among older people with heart failure. Healthcare professionals should help patients take active roles in their self-care through a comprehensive needs assessment including health literacy and disease knowledge.

Background: The purpose of this study was to identify patterns of depressive symptom trajectory and examine the associations of the symptom trajectory with caregiving burden, family function, social support, and perceived health status of caregivers of stroke survivors during the first year of caregiving after discharge from rehabilitation center. Methods: Caregivers of stroke survivors completed a survey of depressive symptoms, caregiving burden, family function, perceived availability of social support, and perceived health status at postdischarge and 1 year. Patterns of depressive symptom trajectory (ie, symptom-free, symptom relieved, symptom developed, and persistent symptom groups) were identified by grouping depressive symptoms based on 2 assessments using the Center for Epidemiologic Studies-Depression. Repeated-measures analysis of variance and multinomial logistic regression were used to examine the associations. Results: Of the 102 caregivers, 57.8% were symptom-free, 20.6% experienced persistent depressive symptoms, 11.8% relieved depressive symptoms, and 9.8% developed depressive symptoms. There were significant changes in family function (Wilks λ = 0.914, P = .038) and perceived health status (Wilks λ = 0.914, P = .033) among the groups during the first year of caregiving. The persistent symptom group reported the highest level of burden and the lowest level of family function and perceived availability of social support at both assessment times. Compared with symptom-free caregivers, caregivers with persistent depressive symptoms were 7 times more likely to have fair/poor health rather than excellent/very good health at 1 year (odds ratio, 7.149; P = .012). Conclusion: Caregivers with persistent depressive symptoms are the most vulnerable to negative psychosocial outcomes and poor perceived health status during the first year of caregiving from discharge for stroke survivors.