Self-reported health and quality of life outcomes of heart failure patients in the aftermath of a national economic crisis: a cross-sectional study
| Autor: | Ketilsdóttir, Auður, Ingadottir, Brynja, Jaarsma, Tiny |
|---|---|
| Přispěvatelé: | Hjúkrunarfræðideild (HÍ), Faculty of Nursing (UI), Heilbrigðisvísindasvið (HÍ), School of Health Sciences (UI), Háskóli Íslands, University of Iceland |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Quality of life
Hälso- och sjukvårdsorganisation hälsopolitik och hälsoekonomi Hjartabilun knowledge heart failure Heart failure sjálfs Health Care Service and Management Health Policy and Services and Health Economy Lífsgæði Sjúklingar Knowledge quality of life Patient-reported outcome measures Symptoms self-care symptoms Self-care Efnahagskreppur patient-reported outcome measures |
| Popis: | Publisher's version (útgefin grein) Aims: There are indications that economic crises can affect public health. The aim of this study was to describe characteristics, health status, and socio-economic status of outpatient heart failure (HF) patients several years after a national economic crisis and to assess whether socio-economic factors were associated with patient-reported outcome measures (PROMs). Methods and results: In this cross-sectional survey, PROMs were measured with seven validated instruments, as follows: self-care (the 12-item European Heart Failure Self-Care Behaviour scale), HF-related knowledge (Dutch Heart Failure Knowledge Scale), symptoms (Edmonton Symptom Assessment System), sense of security (Sense of Security in Care—‘Patients' evaluation’), health status (EQ-5D visual analogue scale), health-related quality of life (HRQoL) (Kansas City Cardiomyopathy Questionnaire), and anxiety and depression (Hospital Anxiety and Depression Scale). Additional data were collected on access and use of health care, household income, demographics, and clinical status. The patients' (n = 124, mean age 73 ± 14.9, 69% male) self-care was low for exercising (53%) and weight monitoring (50%) but optimal for taking medication (100%). HF-specific knowledge was high (correct answers 12 out of 15), but only 38% knew what to do when symptoms worsened suddenly. Patients' sense of security was high (>70% had a mean score of 5 or 6, scale 1–6). The most common symptom was tiredness (82%); 12% reported symptoms of anxiety, and 18% had symptoms of depression. Patients rated their overall health (EQ-5D) on average at 65.5 (scale 0–100), and 33% had poor or very bad HRQoL. The monthly income per household was 90% paid for medications, primary care, and visits to hospital and private clinics out of their own pocket. The cost of health care had changed for 71% of the patients since the 2008 economic crisis, and increased out-of-pocket costs were most often explained by a greater need for health care services and medication expenses. There was no significant difference in PROMs related to changes in out-of-pocket expenses after the crisis, income, or whether patients lived alone or with others. Conclusions: This Icelandic patient population reported similar health-related outcomes as have been previously reported in international studies. This study indicates that even after a financial crisis, most of the patients have managed to prioritize and protect their health even though a large proportion of patients have a low income, use many health care resources, and have insufficient access to care. It is imperative that access and affordable health care services are secured for this vulnerable patient population. This work was supported by Landspítali University Hospital Research Fund, Landspítali, National University Hospital of Iceland; Icelandic Nurses' Association Research Fund; the Maria Finnsdottir Research Fund; and the Heart Failure Association of the ESC Nursing Training Fellowship. |
| Databáze: | OpenAIRE |
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