Health related quality of life and psychological wellbeing in patients with dilated cardiomyopathy
- aDepartment of Psychology, St George's Hospital Medical School, University of London, Cranmer Terrace, London SW17 0RE, UK, bDivision of Cardiological Sciences, St George's Hospital Medical School
- Professor Steptoe
- Accepted 14 October 1999
Abstract
OBJECTIVE To assess the health related quality of life and psychological wellbeing of patients with dilated cardiomyopathy, and relate these to clinical variables and psychological adjustment.
DESIGN Postal questionnaire survey of 99 adult patients with dilated cardiomyopathy, selected at random from a larger database (60.6% response rate). Assessments included the short form 36 (SF-36) health survey, the hospital anxiety and depression scales, the sleep problems index, and a measure of psychological adjustment to cardiomyopathy.
RESULTS Patients with dilated cardiomyopathy reported significant impairments in physical functioning, role limitations owing to physical and emotional problems, social functioning, mental health, perceptions of general health, sleep, and vitality. Anxiety and depression levels were higher than in population samples. Impairment in several domains of quality of life was associated with low shortening fraction, high left ventricular end diastolic diameter, and the presence of heart failure and mitral regurgitation. Patients with familial cardiomyopathy had less impairment in quality of life than those with non-familial disease. Psychological adjustment scores were associated with several aspects of quality of life and emotional wellbeing. In multivariate analysis, demographic and clinical variables accounted for 0.1–40.7% of the variance in different domains of quality of life, and psychological adjustment scores accounted for an additional 0.5–22.4% of variance.
CONCLUSIONS Patients with dilated cardiomyopathy experience pronounced restrictions in quality of life and psychological wellbeing. These limitations are only partly accounted for by symptoms and the severity of underlying disease. Patients may benefit from efforts to improve psychological adjustment to the condition.
