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Objectives

By the end of this section, you will be able to:

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  • decribe the challenges that HF patients live with every day

  • explain how factors affecting quality of life differ between genders

  • describe the emotional effect of HF, and how this is different between men and women

  • describe how the perception of health differs between genders, and how perceived health affects physical health

  • explain the impact of guilt and depression in HF 

     

  • discuss the effect of ascribing feelings to an illness and the power of positive thinking

Quality of Life

Heart failure is so damaging to quality of life (QoL) because of the pervasive way it damages the lungs, skeletal muscle and circulatory system. Patients are often left feeling fatigued, and unable to perform activities of daily living that they deem important [2]. Both men and women complain about the physical and social restrictions that come hand in hand with a HF diagnosis [3][4][5].

Gender is important in determining which QoL factors are most important and how seriously affected a patient will be by certain symptoms. For example women reported that physical symptoms such as dyspnea had the greatest negative effect on their QoL [6]

Common factors that affect QoL

  • Exercise capacity

  • Activities of daily living

  • Sexual activity

  • Work roles

  • Social interactions

Social support is imperative for patients attempting to maintain or improve their QoL. One study found that the risk of fatal and non-fatal cardiovascular events in the year following hospital admissions was significantly decreased with the presence of emotional support. Interestingly, this relationship was only seen in women [7]

One study looked at a group of patients with a matched left ventricle ejection fraction and noticed that women experience significantly lower QoL levels, as well as low physical and social function [8]

The Minnesota Living with Heart Failure Questionnaire (MLHFQ) is a tool commonly used to assess the perceived quality of life in heart failure patients.

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2. Riedinger MS, Dracup KA, Brecht ML, Padilla G, Sarna L, for the SOLVD investigators, and Patricia A Ganz. Quality of life in patients with heart failure: Do gender differences exist? Heart Lung. 2001;30(2):105-16.

3. Martensson J, Karlsson J-E, Fridlund B.Female patients with congestive heart failure: how they conceive their life situation. J Adv Nurs 1998;28:1216 –24.

4. Friedman MM.Str essors and perceived stress in older women with heart disease.Car diovasc Nurs 1993;29:25 –9.

5. Evangelista LS, Kagawa-Singer M, Dracup K.Gender differences in health perceptions and meaning in persons living with heart failure.Heart Lung 2001;30:167 –76.

6. Stromberg A, Martensson J. Gender differences in patients with heart failure. European Journal of Cardiovascular Nursing. 2003;2:7-18.

7. Krumholz HM, Butler J, Miller J, Vaccarino J, Williams C, Mendes de Leon C, Seeman T, Kasl S, Berkman L.Pr ognostic importance of emotional support for elderly patients hospitalized with heart failure.Cir culation 1998;97:958 –64.

8. Clarke KW, Gray D, Hampton JR.Evidence of inadequate investigation and treatment of patients with heart failure.Br Heart J 1994;71:584 –7.

All references for this section