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AIM: Patients with Heart Failure (HF) commonly have poor quality of life (QoL), secondary to the persistence and severity of HF symptoms. We aimed to evaluate the prognostic value of QoL measures on all-cause mortality in patients with HF from the Colombian registry of heart failure (RECOLFACA). METHODS AND RESULTS: We analyzed data from patients registered in RECOLFACA during 2017-2019. QoL was measured using the EuroQol-5D questionnaire (EQ-5D). From the questionnaire, two independent predictors of mortality were obtained, the visual analogue scale (VAS) and the utility score (US). Primary outcome was all-cause mortality, and secondary variables evaluated were demographic factors, comorbidities, NYHA classification, medications used and laboratory test results. To analyze survival among patients, the Kaplan-Meier method and the hierarchical Cox proportional-hazards regression model were used. This study included 2514 patients from RECOLFACA. Most patients were male (57.6%), and mean age was 67.8 years. Mean value and standard deviation (SD) of the VAS score was 78.8 ± 20.1 points, while the mean and SD of the US score was 0.81 ± 0.20. As the Kaplan-Meier curve illustrated, patients in the lower quartiles of both VAS and US scores had a significantly higher probability of mortality (log-rank test: p<0.001 for both scores). CONCLUSION: QoL, as calculated by the EQ-5D questionnaire, served as an independent predictor of mortality in patients from RECOLFACA. Further studies may be needed to evaluate whether provision of optimizing therapies and follow-up care based on patients' perceived QoL reduces short- and long-term mortality rates in this population.
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Objetivo: el objetivo de esta investigación fue describir el perfil, la calidad de vida, la adopción del rol y el afrontamiento y la adaptación de los cuidadores de personas con insuficiencia cardiaca (IC) avanzada, atendidas en el programa Hospital día de la Fundación Clínica Shaio de Bogotá, así como analizar las diferencias en función de sus características sociodemográficas. Metodología: estudio descriptivo transversal realizado en 2019. La población de estudio fueron las personas cuidadoras de pacientes con IC avanzada (N= 128). Se midieron variables sociodemográficas relacionadas con el cuidado, la adopción del rol, el afrontamiento y la adaptación y la calidad de vida. Para analizar los datos se empleó estadística descriptiva y bivariante. Resultados: participaron 101 personas: 81,1% mujeres, de 51,2 años de media, 89,1% de zona urbana, 70,2% con estudios de bachiller o universitario y 81% católicas. El 47% cuidaba de sus progenitores y el 70,4% lo hacía desde hace más de un año. La calidad de vida fue media alta en las dimensiones física y psicológica, media baja en la social y la espiritual; la capacidad de afrontamiento y adaptación fue principalmente media (47,5%) y la adopción del rol se encontró en nivel básico (medio) para la gran mayoría (88,1%). Tuvieron mejor afrontamiento y adopción del rol las personas más jóvenes (Me= 48 aprox.), de zona rural y quienes dedicaban menos horas diarias al cuidado, así como personas de estratos bajos y altos y con alto nivel de compromiso religioso. Conclusión: el nivel educativo y el tiempo de dedicación fue mayor que en otros contextos. Son necesarias estrategias de afrontamiento y adaptación que les permitan apropiarse de su condición y mejorar los resultados obtenidos.(AU)
Objective: the objective of this research was to describe the profile, the quality of life, the role adoption and the coping and adaptation of caregivers for persons with advanced heart failure (HF), managed at the Day Hospital programme of the Fundación Clínica Shaio of Bogotá, as well as to analyse the differences based on their sociodemographic characteristics. Methodology: a descriptive cross-sectional study conducted in 2019. The study population were persons acting as caregivers for patients with Advanced HF (N= 128). Sociodemographic variables were measured, associated with care, role adoption, coping and adaptation, and quality of life. Descriptive and bivariate statistics were conducted. Results: the study included 101 persons: 81.1% were women, with 51.2 years as mean age, 89.1% from urban areas, 70.2% with high school or university degree, and 81% were catholic; 47% were caregivers for their parents, and 70.4% had been doing this for more than one year. The quality of life was medium-high in the physical and psychological dimensions, medium-low in the social and spiritual dimensions. The ability for coping and adaptation was mostly medium (47.5%) and role adoption was found at basic level (medium) for the great majority (88.1%). Younger persons were better at coping and role adoption (mean age= 48 approximately), from rural areas, and those who spent less hours per day in caregiving, as well as those persons from low and high classes and with a high level of religious commitment. Conclusion: the educational level and the time spent in caregiving was higher than in other settings. Coping and adopting strategies are needed, which will allow them to own their condition and improve the results obtained.(AU)