Ethnic differences in quality of life in persons with heart failure.
BACKGROUND
Chronic illness burdens some groups more than others. In studies of ethnic/racial groups with chronic illness, some investigators have found differences in health-related quality of life (HRQL), whereas others have not. Few such comparisons have been performed in persons with heart failure. The purpose of this study was to compare HRQL in non-Hispanic white, black, and Hispanic adults with heart failure.


METHODS
Data for this longitudinal comparative study were obtained from eight sites in the Southwest, Southeast, Northwest, Northeast, and Midwest United States. Enrollment and 3- and 6-month data on 1212 patients were used in this analysis. Propensity scores were used to adjust for sociodemographic and clinical differences among the ethnic/racial groups. Health-related quality of life was measured using the Minnesota Living with Heart Failure Questionnaire.


RESULTS
Significant ethnic/racial effects were demonstrated, with more favorable Minnesota Living with Heart Failure Questionnaire total scores post-baseline for Hispanic patients compared with both black and white patients, even after adjusting for baseline scores, age, gender, education, severity of illness, and care setting (acute vs. chronic), and estimating the treatment effect (intervention vs. usual care). The models based on the physical and emotional subscale scores were similar, with post hoc comparisons indicating more positive outcomes for Hispanic patients than non-Hispanic white patients.


CONCLUSIONS
Cultural differences in the interpretation of and response to chronic illness may explain why HRQL improves more over time in Hispanic patients with heart failure compared with white and black patients.
Riegel
Barbara
B
University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania 19104-6096, USA.
Moser
Debra K
DK
Rayens
Mary Kay
MK
Carlson
Beverly
B
Pressler
Susan J
SJ
Shively
Martha
M
Albert
Nancy M
NM
Armola
Rochelle R
RR
Evangelista
Lorraine
L
Westlake
Cheryl
C
Sethares
Kristen
K
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006333:Heart Failure / Q000208:ethnology* / Q000401:mortality / Q000503:physiopathology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011336:Probability; D011788:Quality of Life; D012372:ROC Curve; D012042:Registries; D018570:Risk Assessment; D012737:Sex Factors; D018434:Sickness Impact Profile; D016019:Survival Analysis; D014481:United States; D044465:White People / Q000706:statistics & numerical data