Factors associated with somatic symptoms perception in patients living with heart failure

Abstract

Funding Acknowledgements Type of funding sources: Other. Main funding source(s): University Review Board of the American University of Beirut Background Heart Failure [HF] affects 64.3 million individuals globally and despite its decreasing global burden it remains dramatically high in countries of the Eastern Mediterranean Region. Self-care is highly recommended to improve HF patient outcomes and an integral aspect for effective HF self-care is symptom perception. This involves body listening, symptom recognition and monitoring, and interpreting and labeling the meaning of these symptoms. Purpose To identify factors related to HF symptom burden as perceived by patients living with HF and using the Heart Failure Somatic Perception [HFSP] scale. Methods This was a secondary analysis of a cross-sectional correlational study that recruited dyads living with HF. Patients were assessed for symptom burden measured by the HFSP scale, depression measured using the Patient Health Questionnaire [PHQ-9], perceived control measured using the Control Attitudes Scale [CAS], and quality of life measured using the Minnesota Living with HF [MLWHF] questionnaire. Independent t-Test and Pearson correlation were used for analysis. Results A total of 109 HF patients [mean age 63.24 ± 10.77 years, 69.7% males] were included. The mean score of HFSP scale was 27.96 ± 19.43. Symptomatic HF patients [New York Functional Class (NYHA) I and II] had significantly higher HFSP than asymptomatic patients [NYHA III and IV] indicating higher symptom burden [32.90 ± 19.65 versus 23.16 ± 17.79; p = 0.11]. Likely, higher symptom burden was associated with lower total quality of life [higher MLWHF score; r = .802; p <.001], lower physical quality of life [r = .802; p <.001], lower emotional quality of life [r = .384; p <.001], more depression [higher PHQ-9 score; r = .464; p <.001], and lower perceived control over symptoms and disease process [lower CAS score; r = -.506; p <.001]. Predictors were retained in the regression model if they contributed significantly to the model or were conceptually relevant and did not negatively affect the variance. Worse quality of life and lower perceived control explained about 60% of the variance in symptom burden [F = 49.189; p = 0.001]. Conclusion Results of this secondary analysis suggest that patients’ somatic perception of their illness has an independent and substantial relationship to their functionality, quality of life, and perceived control over illness. Illness perceptions are amenable to change, and healthcare providers are tasked with developing and testing targeted interventions aimed to modify these as this may be helpful for improving quality of life and control over disease process.