title: Predictors of readmission and health related quality of life in patients with chronic heart failure: a comparison of different psychosocial aspects.
abstract: Psychological distress is common in patients with chronic heart failure. The impact of different psychological variables on prognosis has been shown but the comparative effects of these variables remain unclear. This study examines the impact of depression, anxiety, vital exhaustion, Type D personality, and social support on prognosis in chronic heart failure patients. One hundred eleven patients (mean age 57 ± 14 years) having participated in an exercise based ambulatory cardiac rehabilitation program were enrolled in a prospective cohort study. Psychological baseline data were assessed at program entry. Mortality, readmission, and health-related quality of life were assessed at follow up (mean 2.8 ± 1.1 years). After controlling for disease severity none of the psychological variables were associated with mortality, though severe anxiety predicted readmission [HR = 3.21 (95% CI, 1.04-9.93; P = .042)]. Health-related quality of life was independently explained by vital exhaustion, anxiety and either body mass index (physical dimension) or sex (emotional dimension). As psychological variables have a strong impact on health-related quality of life they should be routinely assessed in chronic heart failure patients` treatment.
authors.affiliation: Division of Social and Behavioral Health Research, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Volz
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Schmid
authors.forename: Marcel
authors.initials: M
authors.lastname: Zwahlen
authors.forename: Sonja
authors.initials: S
authors.lastname: Kohls
authors.forename: Hugo
authors.initials: H
authors.lastname: Saner
authors.forename: Jürgen
authors.initials: J
authors.lastname: Barth
mesh_terms: D001007:Anxiety / Q000209:etiology; D002908:Chronic Disease; D003863:Depression / Q000209:etiology; D005260:Female; D006304:Health Status; D006333:Heart Failure / Q000401:mortality / Q000523:psychology* / Q000534:rehabilitation; D006801:Humans; D016014:Linear Models; D008297:Male; D005222:Mental Fatigue / Q000209:etiology; D008875:Middle Aged; D015999:Multivariate Analysis; D010359:Patient Readmission; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011788:Quality of Life; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology*; D013557:Switzerland / Q000453:epidemiology