Critical review of health-related quality of life studies of patients with aortic stenosis.
BACKGROUND
While studies of health-related quality of life (HRQOL) are increasing among cardiovascular patients, very few have examined HRQOL in persons with aortic stenosis (AS).


OBJECTIVE
A critical review of studies (1997-2008) of HRQOL in persons with AS was conducted to summarize findings and identify clinical and research implications.


RESULTS
Twenty-eight studies were identified, all of which were quantitative and evaluated HRQOL after aortic valve replacement (AVR). No studies conducted by nurses or studies measuring HRQOL in persons who did not undergo AVR were found. The literature focused on age and type of valve as variables influencing HRQOL postoperatively. Although results varied, elderly patients often scored similar or better than comparison groups. Health-related quality of life was found to be affected by valve noise and anticoagulation rather than the specific valve type when comparing patients receiving biological versus mechanical valves.


CONCLUSIONS
Selection for surgery should not be based on age alone. Early consideration should be given to symptoms prior to surgery because of evidence that patients with fewer symptoms preoperatively have better HRQOL after AVR. Anticoagulation status should be evaluated as an independent variable of HRQOL in future studies.


CONCLUSIONS
Researchers need to augment generic HRQOL measures with disease-specific items that may pertain to life areas affected by AS, such as audible valve click, wound healing, and dyspnea. Future research should be inclusive of AS patients who do not undergo surgery. Nurses in a variety of roles can work independently or within a multidisciplinary team to provide interventions for the promotion of HRQOL for patients across all stages of the AS disease process.
Intensive Care Unit, Mercy Hospital, Coon Rapids, Minnesota 55433, USA. lalewno@hotmail.com
Laura Beth
LB
Nugteren
Kristin E
KE
Sandau
D000367:Age Factors; D000925:Anticoagulants / Q000009:adverse effects; D001024:Aortic Valve Stenosis / Q000451:nursing / Q000523:psychology / Q000601:surgery; D001294:Attitude to Health; D005500:Follow-Up Studies; D006293:Health Promotion; D006304:Health Status; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000451:nursing / Q000523:psychology*; D006801:Humans; D024802:Nurse's Role; D015404:Nursing Methodology Research; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011788:Quality of Life / Q000523:psychology*; D012107:Research Design
D000925:Anticoagulants