title: Testing a published model of health-related quality of life in heart failure.
abstract: BACKGROUND
  Health-related quality of life (HRQOL) in patients with heart failure is compromised and associated with increased mortality and rehospitalization. Inadequate conceptualization of variables related to HRQOL has hampered clinicians' efforts to enhance HRQOL. The purpose of this study was to test the Wilson and Cleary model (WCM) of HRQOL in patients with heart failure.
  
  
  RESULTS
  Data from 293 patients with heart failure were analyzed to determine the best multivariate HRQOL model given variables derived from WCM. HRQOL was measured using the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Health perception, symptom status, and age predicted the total MLHFQ (P < .0001) and the emotional scale (P < .0001), and health perception, symptom status, New York Heart Association predicted the physical scale (P < .0001). Health perception was a mediator of the effect of symptom status on HRQOL. Functional status was not a mediator of the effect of symptom status on health perception.
  
  
  CONCLUSIONS
  The most influential variables associated with HRQOL were the subjective variables: health perception and symptom status. Objective variables proposed by WCM to drive the model were not significant predictors. Mediator effects hypothesized in the WCM were not fully demonstrated in this sample. Thus modification of the WCM is warranted.
authors.affiliation: University of Kentucky, College of Medicine, Lexington, Kentucky, USA.
authors.forename: Seongkum
authors.initials: S
authors.lastname: Heo
authors.forename: Debra K
authors.initials: DK
authors.lastname: Moser
authors.forename: Barbara
authors.initials: B
authors.lastname: Riegel
authors.forename: Lynne A
authors.initials: LA
authors.lastname: Hall
authors.forename: Norma
authors.initials: N
authors.lastname: Christman
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000368:Aged; D005260:Female; D006304:Health Status; D006333:Heart Failure / Q000523:psychology*; D006801:Humans; D008297:Male; D015233:Models, Statistical; D011237:Predictive Value of Tests; D011379:Prognosis; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012494:Sampling Studies; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires