The Analysis of the Relationship between the Quality of Life Level and Expectations of Patients with Cardiovascular Diseases under the Home Care of Primary Care Nurses

Abstract

The World Health Organization defines quality of life as a person’s perception of his or her life situation in relation to the culture and value system in which he or she lives, in relation to and with respect to his or her functioning assumptions, expectations, and standards set by environmental conditions. Meeting the expectations of patients with CVD is one of the factors that positively influences their health status and leads to better diagnostic and treatment outcomes. The aim of this study was to answer three main questions related to patients with chronic cardiovascular disease: (1) What is their quality of life? (2) Are patients’ expectations about the quality of care provided by primary health care physicians/nurses met (and at what level)? (3) Is there a correlation between patients’ quality of life and their expectations of primary health care physicians/nurses? The study involved 193 Polish CVD patients who were cared for at home by a family nurse practitioner working in primary health care facilities. Data were collected from March 2016 to January 2017. The WHOQOL-BREF Quality of Life Questionnaire and the Author Interview Questionnaire were used for the study. Data analysis was based on the Spearman correlation coefficient test. There was a statistically significant association between patients’ expectations of the physician regarding information about the course of the disease and quality of life in the following domains: environmental r = 0.20, p = 0.006, psychological: r = 0.18, p = 0.015, physical: r = 0.18, p = 0.013, and social: r = 0.16, p = 0.025. Patients who did not expect the nurse to be courteous, understanding, or interested were found to have higher quality of life scores in psychological (r = −0.17, p = 0.023) and physical (r = −0.15, p = 0.044) domains. There was a statistically significant relationship between expectations of care from nurses regarding intimacy during care activities and the level of satisfaction with one’s own health (r = −0.15, p = 0.038) and quality of life (r = −0.14, p = 0.045), as well as quality of life in the domains of physical (r = 0.21, p = 0.004), social (r = 0.19, p = 0.010), and psychological (r = 0.16, p = 0.024). There is a need to define the expectations of patients with chronic cardiovascular disease in primary care, as lack of expectations of a physician/nurse continues to be associated with lower quality of life in all domains.

“To Be Treated as a Person and Not as a Disease Entity”—Expectations of People with Visual Impairments towards Primary Healthcare: Results of the Mixed-Method Survey in Poland

“…Respondents with VIs who regarded their quality of life as very good presented higher expectations for the Accessibility of care dimension. Similarly, in a Polish study conducted on patients with some chronic diseases [ 59 ], a lower quality of life corresponded with a lack of expectations for a physician or nurse. We assume that people who asses their quality of life as good may more often promote active lifestyle, be determined to care about their health and hence, appreciate access to healthcare more.…”

Indicators of integrated care for patients with chronic cardiovascular disease in ambulatory care

“…4 Given the expected incidence of CVD and demographic changes, a more effective and targeted model of care for patients with chronic CVD needs to be developed. 2,[12][13][14][15] In addition, the Polish healthcare system is characterized by fragmented healthcare administration (which significantly complicates coordination at the systemic level) and relatively low healthcare spending. 16 These features make it necessary to study the requirements, practices and challenges of integrating care for people with CVD in the country.…”

“…12 It should be noted that, in recent years, there has been a return to the promotion of holistic care, defined as a caring approach that is more concerned about the patient and takes into account all of their needs, goals and values. [12][13][14][15] In addition, available research emphasizes that integration of care should focus on a comprehensive approach to care and multidisciplinary collaboration. 3,17 There is also evidence that the social dimension needs to be integrated into health service delivery to meet the population health needs.…”

“…All of the above consequences associated with CVD can be measured and detected by assessing patients' quality of life indicators. 15,18 Significantly, assessing the quality of life affects the efficiency of medical treatment and makes therapeutic options more accessible and acceptable to patients. Quality of life is also perceived as an indicator of the effectiveness of current political and social support systems.…”

“…Quality of life is also perceived as an indicator of the effectiveness of current political and social support systems. 15,[18][19][20][21] A correlation between the quality of life in patients with CVD and point of healthcare has been demonstrated. 15 Another critical topic is the health-promoting behaviors of CVD patients.…”