title: Correlates of quality of life in rural patients with heart failure.
abstract: BACKGROUND
  There is abundant research indicating poor physical, psychological, and social functioning of patients with chronic heart failure (HF), a reality that can lead to poor health-related quality of life (QoL). Little is known about the experience of rural patients with HF.
  
  
  RESULTS
  This study was part of a randomized clinical trial titled Rural Education to Improve Outcomes in Heart Failure (REMOTE-HF) designed to test an education and counseling intervention to improve self-care in patients with HF. We evaluated 612 rural patients. Multiple validated questionnaires were administered to assess patient perceptions of health and health literacy. Baseline factors were collected and compared with baseline QoL measures only. Patients' health-related QoL was assessed using the Minnesota Living with Heart Failure scale. The data were analyzed using a general linear model to test the association of various patient characteristics with QoL in rural patients with HF. Patients were 65.8 (+12.9) years of age. The majority were men (58.7%), married (56.4%), and had completed a high-school education (80.9%). Factors associated with reduced QoL among this population include geographic location, younger age, male sex, higher New York Heart Association class, worse HF knowledge, poorer perceived control, and symptoms of depression or anxiety. The data provided no evidence of an association between left ventricular ejection fraction and QoL.
  
  
  CONCLUSIONS
  This study of rural patients with HF confirms previously identified factors associated with perceptions of QoL. However, further study is warranted with an urban control group.
  
  
  BACKGROUND
  http://www.clinicaltrials.gov. Unique identifier: NCT00415545.
authors.affiliation: From the School of Medicine, Associate Vice Chancellor for Strategic Technologies and Alliances (T.N.), School of Medicine (S.D.), Division of Cardiovascular Medicine (J.A.S.), Department of Internal Medicine (S.S.), Clinical Translational Science Center (A.F.), Center for Health and Technology (K.M.), and School of Medicine, Division of Biostatistics (M.D.W.), University of California, Davis; Center for Biobehavioral Research in Self-Management of Cardiopulmonary Disease, College of Nursing, University of Kentucky, Lexington (D.K.M.); Orvis School of Nursing, University of Nevada, Reno (M.M.P.); School of Nursing, Department of Physiological Nursing, University of California, San Francisco (S.R., K.D.); and National Heart, Lung, and Blood Institute, Bethesda, MD (L.C.).
authors.forename: Thomas
authors.initials: T
authors.lastname: Nesbitt
authors.affiliation: From the School of Medicine, Associate Vice Chancellor for Strategic Technologies and Alliances (T.N.), School of Medicine (S.D.), Division of Cardiovascular Medicine (J.A.S.), Department of Internal Medicine (S.S.), Clinical Translational Science Center (A.F.), Center for Health and Technology (K.M.), and School of Medicine, Division of Biostatistics (M.D.W.), University of California, Davis; Center for Biobehavioral Research in Self-Management of Cardiopulmonary Disease, College of Nursing, University of Kentucky, Lexington (D.K.M.); Orvis School of Nursing, University of Nevada, Reno (M.M.P.); School of Nursing, Department of Physiological Nursing, University of California, San Francisco (S.R., K.D.); and National Heart, Lung, and Blood Institute, Bethesda, MD (L.C.).
authors.forename: Sahar
authors.initials: S
authors.lastname: Doctorvaladan
authors.affiliation: From the School of Medicine, Associate Vice Chancellor for Strategic Technologies and Alliances (T.N.), School of Medicine (S.D.), Division of Cardiovascular Medicine (J.A.S.), Department of Internal Medicine (S.S.), Clinical Translational Science Center (A.F.), Center for Health and Technology (K.M.), and School of Medicine, Division of Biostatistics (M.D.W.), University of California, Davis; Center for Biobehavioral Research in Self-Management of Cardiopulmonary Disease, College of Nursing, University of Kentucky, Lexington (D.K.M.); Orvis School of Nursing, University of Nevada, Reno (M.M.P.); School of Nursing, Department of Physiological Nursing, University of California, San Francisco (S.R., K.D.); and National Heart, Lung, and Blood Institute, Bethesda, MD (L.C.). jeffrey.southard@ucdmc.ucdavis.edu.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Southard
authors.affiliation: From the School of Medicine, Associate Vice Chancellor for Strategic Technologies and Alliances (T.N.), School of Medicine (S.D.), Division of Cardiovascular Medicine (J.A.S.), Department of Internal Medicine (S.S.), Clinical Translational Science Center (A.F.), Center for Health and Technology (K.M.), and School of Medicine, Division of Biostatistics (M.D.W.), University of California, Davis; Center for Biobehavioral Research in Self-Management of Cardiopulmonary Disease, College of Nursing, University of Kentucky, Lexington (D.K.M.); Orvis School of Nursing, University of Nevada, Reno (M.M.P.); School of Nursing, Department of Physiological Nursing, University of California, San Francisco (S.R., K.D.); and National Heart, Lung, and Blood Institute, Bethesda, MD (L.C.).
authors.forename: Satinder
authors.initials: S
authors.lastname: Singh
authors.affiliation: From the School of Medicine, Associate Vice Chancellor for Strategic Technologies and Alliances (T.N.), School of Medicine (S.D.), Division of Cardiovascular Medicine (J.A.S.), Department of Internal Medicine (S.S.), Clinical Translational Science Center (A.F.), Center for Health and Technology (K.M.), and School of Medicine, Division of Biostatistics (M.D.W.), University of California, Davis; Center for Biobehavioral Research in Self-Management of Cardiopulmonary Disease, College of Nursing, University of Kentucky, Lexington (D.K.M.); Orvis School of Nursing, University of Nevada, Reno (M.M.P.); School of Nursing, Department of Physiological Nursing, University of California, San Francisco (S.R., K.D.); and National Heart, Lung, and Blood Institute, Bethesda, MD (L.C.).
authors.forename: Anne
authors.initials: A
authors.lastname: Fekete
authors.affiliation: From the School of Medicine, Associate Vice Chancellor for Strategic Technologies and Alliances (T.N.), School of Medicine (S.D.), Division of Cardiovascular Medicine (J.A.S.), Department of Internal Medicine (S.S.), Clinical Translational Science Center (A.F.), Center for Health and Technology (K.M.), and School of Medicine, Division of Biostatistics (M.D.W.), University of California, Davis; Center for Biobehavioral Research in Self-Management of Cardiopulmonary Disease, College of Nursing, University of Kentucky, Lexington (D.K.M.); Orvis School of Nursing, University of Nevada, Reno (M.M.P.); School of Nursing, Department of Physiological Nursing, University of California, San Francisco (S.R., K.D.); and National Heart, Lung, and Blood Institute, Bethesda, MD (L.C.).
authors.forename: Kate
authors.initials: K
authors.lastname: Marie
authors.affiliation: From the School of Medicine, Associate Vice Chancellor for Strategic Technologies and Alliances (T.N.), School of Medicine (S.D.), Division of Cardiovascular Medicine (J.A.S.), Department of Internal Medicine (S.S.), Clinical Translational Science Center (A.F.), Center for Health and Technology (K.M.), and School of Medicine, Division of Biostatistics (M.D.W.), University of California, Davis; Center for Biobehavioral Research in Self-Management of Cardiopulmonary Disease, College of Nursing, University of Kentucky, Lexington (D.K.M.); Orvis School of Nursing, University of Nevada, Reno (M.M.P.); School of Nursing, Department of Physiological Nursing, University of California, San Francisco (S.R., K.D.); and National Heart, Lung, and Blood Institute, Bethesda, MD (L.C.).
authors.forename: Debra K
authors.initials: DK
authors.lastname: Moser
authors.affiliation: From the School of Medicine, Associate Vice Chancellor for Strategic Technologies and Alliances (T.N.), School of Medicine (S.D.), Division of Cardiovascular Medicine (J.A.S.), Department of Internal Medicine (S.S.), Clinical Translational Science Center (A.F.), Center for Health and Technology (K.M.), and School of Medicine, Division of Biostatistics (M.D.W.), University of California, Davis; Center for Biobehavioral Research in Self-Management of Cardiopulmonary Disease, College of Nursing, University of Kentucky, Lexington (D.K.M.); Orvis School of Nursing, University of Nevada, Reno (M.M.P.); School of Nursing, Department of Physiological Nursing, University of California, San Francisco (S.R., K.D.); and National Heart, Lung, and Blood Institute, Bethesda, MD (L.C.).
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Pelter
authors.affiliation: From the School of Medicine, Associate Vice Chancellor for Strategic Technologies and Alliances (T.N.), School of Medicine (S.D.), Division of Cardiovascular Medicine (J.A.S.), Department of Internal Medicine (S.S.), Clinical Translational Science Center (A.F.), Center for Health and Technology (K.M.), and School of Medicine, Division of Biostatistics (M.D.W.), University of California, Davis; Center for Biobehavioral Research in Self-Management of Cardiopulmonary Disease, College of Nursing, University of Kentucky, Lexington (D.K.M.); Orvis School of Nursing, University of Nevada, Reno (M.M.P.); School of Nursing, Department of Physiological Nursing, University of California, San Francisco (S.R., K.D.); and National Heart, Lung, and Blood Institute, Bethesda, MD (L.C.).
authors.forename: Susan
authors.initials: S
authors.lastname: Robinson
authors.affiliation: From the School of Medicine, Associate Vice Chancellor for Strategic Technologies and Alliances (T.N.), School of Medicine (S.D.), Division of Cardiovascular Medicine (J.A.S.), Department of Internal Medicine (S.S.), Clinical Translational Science Center (A.F.), Center for Health and Technology (K.M.), and School of Medicine, Division of Biostatistics (M.D.W.), University of California, Davis; Center for Biobehavioral Research in Self-Management of Cardiopulmonary Disease, College of Nursing, University of Kentucky, Lexington (D.K.M.); Orvis School of Nursing, University of Nevada, Reno (M.M.P.); School of Nursing, Department of Physiological Nursing, University of California, San Francisco (S.R., K.D.); and National Heart, Lung, and Blood Institute, Bethesda, MD (L.C.).
authors.forename: Machelle D
authors.initials: MD
authors.lastname: Wilson
authors.affiliation: From the School of Medicine, Associate Vice Chancellor for Strategic Technologies and Alliances (T.N.), School of Medicine (S.D.), Division of Cardiovascular Medicine (J.A.S.), Department of Internal Medicine (S.S.), Clinical Translational Science Center (A.F.), Center for Health and Technology (K.M.), and School of Medicine, Division of Biostatistics (M.D.W.), University of California, Davis; Center for Biobehavioral Research in Self-Management of Cardiopulmonary Disease, College of Nursing, University of Kentucky, Lexington (D.K.M.); Orvis School of Nursing, University of Nevada, Reno (M.M.P.); School of Nursing, Department of Physiological Nursing, University of California, San Francisco (S.R., K.D.); and National Heart, Lung, and Blood Institute, Bethesda, MD (L.C.).
authors.forename: Lawton
authors.initials: L
authors.lastname: Cooper
authors.affiliation: From the School of Medicine, Associate Vice Chancellor for Strategic Technologies and Alliances (T.N.), School of Medicine (S.D.), Division of Cardiovascular Medicine (J.A.S.), Department of Internal Medicine (S.S.), Clinical Translational Science Center (A.F.), Center for Health and Technology (K.M.), and School of Medicine, Division of Biostatistics (M.D.W.), University of California, Davis; Center for Biobehavioral Research in Self-Management of Cardiopulmonary Disease, College of Nursing, University of Kentucky, Lexington (D.K.M.); Orvis School of Nursing, University of Nevada, Reno (M.M.P.); School of Nursing, Department of Physiological Nursing, University of California, San Francisco (S.R., K.D.); and National Heart, Lung, and Blood Institute, Bethesda, MD (L.C.).
authors.forename: Kathleen
authors.initials: K
authors.lastname: Dracup
mesh_terms: D000368:Aged; D005260:Female; D015438:Health Behavior; D006333:Heart Failure; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012424:Rural Population
keywords: heart failure; quality of life; rural population