Thomas Nesbitt1, Sahar Doctorvaladan1, Jeffrey A Southard2, Satinder Singh1, Anne Fekete1, Kate Marie1, Debra K Moser1, Michelle M Pelter1, Susan Robinson1, Machelle D Wilson1, Lawton Cooper1, Kathleen Dracup1. 1. 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.). 2. 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.
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. METHODS AND 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. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00415545.
RCT Entities:
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. METHODS AND 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. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00415545.
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