The influence of chronic heart failure in patient-partner dyads--a comparative study addressing issues of health-related quality of life.
BACKGROUND
Patients with chronic heart failure (HF) and their partners face many challenges associated with heart disease. High social support in a close relationship has been found to improve survival in patients with HF. However, caring for a patient with HF may have negative effects on the health-related quality of life (HRQOL) of the partner responsible for the care. The main focus in health care is still on improving patients' HRQOL, but the awareness of partners' and families' role and situation is increasing. Therefore, further studies are needed to clarify these issues and the importance of partners in relation to HRQOL of patients with HF.


OBJECTIVE
To describe and compare HRQOL, quality-adjusted life-year (QALY) weights, symptoms of depression, and perceived control and knowledge in patients with chronic HF and their partners and to compare HRQOL and QALY weights in the partners with an age- and sex-matched group.


METHODS
Data were collected from 135 patient-partner dyads at 2 Swedish hospitals. Data on the reference group were collected from the same region.


RESULTS
Patients had lower HRQOL in all dimensions (P<.001) except in the mental health domain and lower QALY weights compared with their partners (P<.001). Mental health scores were lower in partners compared with the age- and sex-matched references (P<.001). All other HRQOL scores and the QALY weights were comparable between partners and reference group. Patients had more depressive symptoms than did their partners (P<.001). There was no difference in the level of perceived control or knowledge about chronic HF between patients and partners.


CONCLUSIONS
Our findings confirm that partners of patients with chronic HF have markedly diminished mental health. Interventions focusing on education and psychosocial support may potentially promote mental health in partners and enhance their ability to support the patient.
Susanna Ågren, PhD, RN Medical Doctor, Department of Medical and Health Sciences, Division of Nursing Science, Linköping University; Department of Cardiothoracic Surgery, Linköping University Hospital; and The Swedish Institute for Health Sciences, Lund, Sweden. Lorraine Evangelista, PhD, RN Senior Lecturer, School of Nursing, University of California, Los Angeles. Thomas Davidson, PhD Health Economist, Department of Medical and Health Sciences, Center for Medical Technology Assessment, Linköping University, Sweden. Anna Strömberg, PhD, RN Professor, Department of Medical and Health Sciences, Division of Nursing Science, Linköping University; and Department of Cardiology Linköping University Hospital, Sweden.
Susanna
S
Ågren
Lorraine
L
Evangelista
Thomas
T
Davidson
Anna
A
Strömberg
D000328:Adult; D017028:Caregivers / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D005192:Family Health; D005260:Female; D006333:Heart Failure / Q000401:mortality; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life; D019057:Quality-Adjusted Life Years