Quality Of Life And Its Predictors Among Patients With Coronary Heart Disease

Background:The incidence and mortality of coronary heart disease continue to rise.The quality of life among patients is poor and need to be improved.Identifying the predictors in patient’s quality of life is the key to improving their quality of life.The purpose of this study was to analyze the current quality of life among patients with coronary heart disease in China.And to explore its predictors and mechanisms to provide theoretical support for the development of nursing interventions to improve quality of life.Objective: Exploring the predictors and mechanism about quality of life in patients with coronary heart disease.Provide theoretical support for the development of interventions to improve the quality of life of patients with coronary heart disease.Methods 1.Review the theoretical model about quality of life,the predictors about quality of life in coronary heart disease and measurement tools.2.A survey was conducted among 392 patients with coronary heart disease by convenient sampling method.3.The predictors influencing the quality of life and the mechanism of action of patients with coronary heart disease were analyzed by single factor analysis,multiple linear regression and structural equation modeling.Results 1.The overall score of quality of life in patients is(72.46±16.15),which is higher than that in Chinese norm with coronary heart disease.2.Univariate analysis shows: Self-care agency,social support,general health and physical functioning were positively correlated to quality of life.Patients with anxiety,depression and type-D personality had lower quality of life.3.The results of multiple regression analysis shows:The factors which influencing the quality of life in patients with coronary heart disease are ranked as Cardiac function grading,physical functioning,general health,self-care confidence,anxiety,social support,health education,type-D personality,self-care maintenance,self-care management,work status,marital status and monthly income.These variables can collectively explain the 83.2% variation in quality of life.4.Structural equation model shows 8 significant paths affecting the quality of life in patients with coronary heart disease.Social support → quality of life.Self-care agency → quality of life.General health → quality of life.Type D personality → general health → quality of life.Physical functioning → general health → quality of life.Anxiety → physical functioning → general health → quality of life.Social support → physical functioning → general health → quality of life.Self-care agency → anxiety → physical functioning → general health → quality of life.General health has a direct effect on quality of life.Type D personality,physical functioning,and anxiety have an indirect effect on quality of life.Social support and self-care agency have both direct and indirect effects on quality of life.The relationship between the total effect of each variable on quality of life are ranked as social support(0.431),general health(0.321),self-care agency(0.207),physical functioning(0.132),type D personality(-0.053),anxiety(-0.039).Type D personality and anxiety are negative effects and the others are positive effects.Conclusion 1.The quality of life in patients with coronary heart disease in Hangzhou is better than that in Chinese coronary heart disease patients.2.Social support,general health,self-care agency and physical function are important factors influencing quality of life.Anxiety and D-type personality have less impact on quality of life.Quality of life can be improved by increasing social support,improving physical function and self-care agency.3.Wilson-Cleary health-related quality of life model can provide theoretical support for the research about quality of life in patients with coronary heart disease in China.