Predicting Self-Rated Health in Diabetes and Chronic Heart Failure – A Multiple Mediation Model

Böhme, Sylvia; Renneberg, Babette

doi:10.3389/fpubh.2015.00266

Cited by 9 publications

(12 citation statements)

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“…Persisting symptoms and poor HRQoL after optimisation of HF treatments [ 7 ] suggest that comorbidities may be an important determinant of health and that non-cardiovascular comorbidities may be associated with HF-related symptoms [ 8 ]. However, the evidence is inconsistent, with some HF studies showing associations between comorbidities and HRQoL [ 9 – 11 ] and others showing no such associations [ 12 , 13 ]. Whilst comorbidities are consistent predictors of morbidity and mortality in HF [ 14 ], their interrelationships with symptoms, functional limitations, and overall health have not been explored.…”

Section: Introductionmentioning

confidence: 99%

Comorbidity health pathways in heart failure patients: A sequences-of-regressions analysis using cross-sectional data from 10,575 patients in the Swedish Heart Failure Registry

et al. 2018

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BackgroundOptimally treated heart failure (HF) patients often have persisting symptoms and poor health-related quality of life. Comorbidities are common, but little is known about their impact on these factors, and guideline-driven HF care remains focused on cardiovascular status. The following hypotheses were tested: (i) comorbidities are associated with more severe symptoms and functional limitations and subsequently worse patient-rated health in HF, and (ii) these patterns of association differ among selected comorbidities.Methods and findingsThe Swedish Heart Failure Registry (SHFR) is a national population-based register of HF patients admitted to >85% of hospitals in Sweden or attending outpatient clinics. This study included 10,575 HF patients with patient-rated health recorded during first registration in the SHFR (1 February 2008 to 1 November 2013). An a priori health model and sequences-of-regressions analysis were used to test associations among comorbidities and patient-reported symptoms, functional limitations, and patient-rated health. Patient-rated health measures included the EuroQol–5 dimension (EQ-5D) questionnaire and the EuroQol visual analogue scale (EQ-VAS). EQ-VAS score ranges from 0 (worst health) to 100 (best health). Patient-rated health declined progressively from patients with no comorbidities (mean EQ-VAS score, 66) to patients with cardiovascular comorbidities (mean EQ-VAS score, 62) to patients with non-cardiovascular comorbidities (mean EQ-VAS score, 59). The relationships among cardiovascular comorbidities and patient-rated health were explained by their associations with anxiety or depression (atrial fibrillation, odds ratio [OR] 1.16, 95% CI 1.06 to 1.27; ischemic heart disease [IHD], OR 1.20, 95% CI 1.09 to 1.32) and with pain (IHD, OR 1.25, 95% CI 1.14 to 1.38). Associations of non-cardiovascular comorbidities with patient-rated health were explained by their associations with shortness of breath (diabetes, OR 1.17, 95% CI 1.03 to 1.32; chronic kidney disease [CKD, OR 1.23, 95% CI 1.10 to 1.38; chronic obstructive pulmonary disease [COPD], OR 95% CI 1.84, 1.62 to 2.10) and with fatigue (diabetes, OR 1.27, 95% CI 1.13 to 1.42; CKD, OR 1.24, 95% CI 1.12 to 1.38; COPD, OR 1.69, 95% CI 1.50 to 1.91). There were direct associations between all symptoms and patient-rated health, and indirect associations via functional limitations. Anxiety or depression had the strongest association with functional limitations (OR 10.03, 95% CI 5.16 to 19.50) and patient-rated health (mean difference in EQ-VAS score, −18.68, 95% CI −23.22 to −14.14). HF optimizing therapies did not influence these associations. Key limitations of the study include the cross-sectional design and unclear generalisability to other populations. Further prospective HF studies are required to test the consistency of the relationships and their implications for health.ConclusionsIdentification of distinct comorbidity health pathways in HF could provide the evidence for individualised person-centred care that targets speci...

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Section: Introductionmentioning

confidence: 99%

Comorbidity health pathways in heart failure patients: A sequences-of-regressions analysis using cross-sectional data from 10,575 patients in the Swedish Heart Failure Registry

et al. 2018

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“…5 Nesse contexto, a saúde autorreferida (SAR) tem sido incorporada como um dos instrumentos padronizados que mensuram a qualidade de vida. 6 A SAR vem sendo amplamente utilizada em pesquisas clínicas e epidemiológicas, a qual leva em consideração dimensões físicas, psicológicas e sociais 7,8 e por isso, vem sendo demonstrada sua importância como preditora de morbidade e mortalidade na IC. 6,9 Vários inquéritos utilizaram a SAR como indicador para monitorar o estado de saúde da população.…”

Section: Introductionunclassified

“…6 A SAR vem sendo amplamente utilizada em pesquisas clínicas e epidemiológicas, a qual leva em consideração dimensões físicas, psicológicas e sociais 7,8 e por isso, vem sendo demonstrada sua importância como preditora de morbidade e mortalidade na IC. 6,9 Vários inquéritos utilizaram a SAR como indicador para monitorar o estado de saúde da população. 8,10,11 Em vista disso, o inquérito nacional de grande porte, denominado Pesquisa Nacional de Saúde (PNS), foi conduzido no país em 2013, a partir de amostra representativa da população brasileira e também fez uso desse indicador.…”

Section: Introductionunclassified

Prevalência de insuficiência cardíaca e associação com saúde autorreferida no Brasil

Nogueira

Fonsêca

et al. 2019

Acta Fisiátr.

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A insuficiência cardíaca (IC) é um desafio na saúde mundial. A saúde autorreferida (SAR) é preditora de morbimortalidade e é categorizada em saúde autorreferida boa (SAR B) e precária (SAR P). Objetivo: Estimar a prevalência da IC e associação com a SAR no Brasil. Métodos: Este estudo utilizou dados da Pesquisa Nacional de Saúde (PNS) em 2013, com dados válidos para 59.655 adultos (≥ 18 anos). A prevalência de IC relacionou-se às características sociodemográficas, percepção do estado de saúde (SAR, percepções de saúde física e mental), diagnóstico de depressão e prática de exercício físico. Utilizou-se a regressão de Poisson com variância robusta. Resultados: O diagnóstico de IC foi referido por 1,1% dos entrevistados. Observou-se que ter o diagnóstico médico de IC aumenta em quatro vezes a chance de ter pior percepção de saúde (OR = 4,17; IC95% 3,65–4,76), contudo essa medida reduz para menos da metade, quando ajustado por faixa etária e percepção da saúde física (OR = 1,78; IC95% 1,52–2,08). Conclusão: A prevalência de IC representou 1,7 milhões de indivíduos com essa enfermidade na população brasileira. A estreita associação entre IC e SAR precária evidenciou aumento de 78% de chance do indivíduo que tenha IC relatar SAR precária.

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“…Psychological factors associated with SRH include a satisfying relationship with family and friends (16), individual emotional well-being (21) and self-esteem and optimism (22). According to Cai et al, depression is the strongest predictor of SRH, especially in women and elderly people (16).…”

Section: Introductionmentioning

confidence: 99%

“…However, the impact of the last factor is ambiguous. According to B€ ohme & Renneberg, in the group of diabetics or those with chronic heart failure (CHF) or patients with both diseases simultaneously, the number of co-occurring diseases is not a predictor of SRH (21). A high intensity of pain is associated with poorer SRH in patients who were orthopaedically operated (25), long-term care residents (26) and elderly patients of a GP (24).…”

Section: Introductionmentioning

confidence: 99%

Self‐rated health in mothers of children hospitalised for severe illnesses and mothers of healthy children: cross‐sectional study

Aftyka

Rosa

Taczała

2019

Scandinavian Caring Sciences

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Introduction Self‐rated health (SRH) is a recognised tool for predicting morbidity and mortality. Aim The aim of the study was to investigate and compare SRH in a group of mothers of hospitalised children and mothers of healthy children and to indicate the variables associated with poor SRH in both groups. Methods We conducted questionnaire‐based cross‐sectional research in a group of 184 women. Half of the respondents (n = 92) were the mothers of children hospitalised for a severe illnesses (Group H). The control group (n = 92) comprised mothers of healthy children (Group C). Self‐Rated Health (SRH), Numerical Rating Scale (NRS), Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale‐Revised (IES‐R) and Interpersonal Support Evaluation List (ISEL‐40 v. GP) were used. In order to facilitate critical appraisal and interpretation of results, STROBE recommendations were used. Results The prevalence of poor SRH was greater in mothers of children hospitalised for a severe illness than in those of healthy children (35 and 19%, respectively). In both groups, the risk of poor SRH was statistically significantly higher in those mothers who for the past 7 days reported at least moderate pain and in mothers who manifested anxiety symptoms. In both groups, the prevalence of poor SRH was statistically significantly lower if the respondents' children were in good health. The risk of poor SRH was associated with poor financial status in group H and with depression and at least moderate pain for the past 7 days in group C. Relevance to clinical practice In order to provide mothers of severely ill children with high‐quality health care including preventive measures, it is recommended that their health is assessed by healthcare professionals.

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Predicting Self-Rated Health in Diabetes and Chronic Heart Failure – A Multiple Mediation Model

Cited by 9 publications

References 41 publications

Comorbidity health pathways in heart failure patients: A sequences-of-regressions analysis using cross-sectional data from 10,575 patients in the Swedish Heart Failure Registry

Comorbidity health pathways in heart failure patients: A sequences-of-regressions analysis using cross-sectional data from 10,575 patients in the Swedish Heart Failure Registry

Prevalência de insuficiência cardíaca e associação com saúde autorreferida no Brasil

Self‐rated health in mothers of children hospitalised for severe illnesses and mothers of healthy children: cross‐sectional study

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