title: Factors and interventions influencing health-related quality of life in patients with heart failure: a review of the literature.
abstract: BACKGROUND
  Because of the lack of a cure for patients with chronic heart failure (HF), there has been a progressive interest in the use of health-related quality of life (Hr-QoL) as complementary end-point to mortality and morbidity.
  
  
  OBJECTIVE
  The aim of this review was from a nursing perspective to describe Hr-QoL and the influencing factors of Hr-QoL, as well as to identify interventions aimed at influencing Hr-QoL in HF patients.
  
  
  METHODS
  Medline, Cinahl and PsycInfo databases were searched from 1995 to 2004. A total of 58 papers were included.
  
  
  RESULTS
  HF symptoms and activity status influence Hr-QoL negatively. However, several individual characteristics such as personality, gender and age must also be taken into consideration because different values might exist regarding what constitutes a good Hr-QoL. Nurse led interventions based on education, support and exercise can influence Hr-QoL positively. There is also a need of more studies about the effects of depression, sleep disturbances, support as well as education on Hr-QoL. There is also a need of exercise studies with larger sample sizes and older patients in higher NYHA classes.
  
  
  CONCLUSIONS
  Several individual factors impact Hr-QoL, therefore, must nursing interventions are individually adapted to the patient's resources.
authors.affiliation: Department of Cardiology, Linköping University Hospital, S-58185 Linköping, Sweden. PeterJohansson@mbox309.swipnet.se
authors.forename: Peter
authors.initials: P
authors.lastname: Johansson
authors.forename: Ulf
authors.initials: U
authors.lastname: Dahlström
authors.forename: Anders
authors.initials: A
authors.lastname: Broström
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000367:Age Factors; D001294:Attitude to Health; D017281:Cost of Illness; D003863:Depression / Q000209:etiology; D004417:Dyspnea / Q000209:etiology; D015444:Exercise; D005221:Fatigue / Q000209:etiology; D006301:Health Services Needs and Demand; D006304:Health Status; D006333:Heart Failure / Q000150:complications / Q000451:nursing / Q000523:psychology*; D006801:Humans; D009730:Nursing Assessment; D015404:Nursing Methodology Research; D010353:Patient Education as Topic; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D018434:Sickness Impact Profile; D012893:Sleep Wake Disorders / Q000209:etiology; D012944:Social Support