PURPOSE: The purpose of this study was to identify the factors that influence the functional status of patients with heart failure. METHOD: A descriptive, correlational study design was used. The participants in this study were 260 patients with heart failure who were admitted at Y University and U University in Seoul, Korea. Between September 2005 and December 2005 data was collected by an interview using a questionnaire and from medical records. The Functional status was measured with KASI. Physical factors (dyspnea, ankle edema, chest pain, fatigue, and sleep dysfunction), psychological factors (anxiety and depression), and situational factors (self-management compliance and family support) were examined. RESULT: In general, the functional status, anxiety, depression, self-management compliance, and family support was relatively not good. The level of fatigue was highest and the level of ankle edema was lowest for physical symptom experiences. In regression analysis, functional status was significantly influenced by dyspnea(23%), age(13%), monthly income(7%), fatigue(3%), ankle edema(2%), depression(1%), and length of stay in the hospital(1%). These factors explained 50% of the variables in the functional status. CONCLUSION: These results suggest that psycho-physiological symptoms management should be a focus to improve the functional status in patients with heart failure.
Affective Symptoms ; Aged ; Aged, 80 and over ; Female ; Health Status ; Heart Failure/*diagnosis/*psychology ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Patient Compliance ; Psychology ; Questionnaires ; Sickness Impact Profile ; Socioeconomic Factors

OBJECTIVETo test the efficacy of intensive clinic follow-up for outpatients with chronic heart failure (CHF) on outcome.

METHODSAll patients diagnosed as CHF in our cardiac center between January 2007 to December 2008 were included in this study. The patients were divided into two intensive follow-up (IF) and usual care (UC) groups. Endpoints including death or rehospitalization, medication, the quality of life evaluated with Minnesota Living with Heart Failure Questionnaire (MLHFQ) and hospital costs were analyzed with the data collected through hospital records or by telephone and post survey.

RESULTSA total of 333 patients were enrolled (108 patients in IF group and 225 in UC group). The mean follow-up duration was 454 days for IF group and 484 days for UC group. Mortality and readmission rate (66.67% vs. 42.59%, P < 0.05) and mortality rate (14.35% vs. 1.85%, P < 0.05) were significantly higher in UC group than in IF group. The percentage of patients receiving ACEI/ARB (86.79% vs. 40.54%, P < 0.05) and beta-adrenergic receptor blocker (89.62% vs. 46.49%, P < 0.05) were higher in IF group than in the UC group. In addition, the percentage of patients receiving target dosage of drugs is also higher in IF group (ACEI/ARB17.92%, BB17.92%) than in UC group (ACEI/ARB8.65%, BB1.62%, P < 0.05, respectively). Furthermore, mean MLHFQ total score (30.7 vs. 37.7, P < 0.05) and hospital cost (3821.51 RMB less per patient in this period) were significantly lower in IF group than in UC group.

CONCLUSIONIntensive clinic follow-up for outpatients with CHF in HF clinic can improve evidence-based treatment, reduce the readmission and death rate, improve quality of life and save hospital cost.

Aged ; Aged, 80 and over ; Follow-Up Studies ; Heart Failure ; diagnosis ; psychology ; therapy ; Humans ; Male ; Middle Aged ; Outpatients ; Patient Compliance ; Prognosis ; Treatment Outcome