The relationship of illness representation and self-care behaviors to health-related quality of life in older individuals with heart failure
Voelmeck, Wayne Francis
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This descriptive correlational study used a convenience sample of 98 individuals with Heart Failure (HF) ages 55 to 97 years (M = 74.4, SD= 10.5) to explore the relationships between the illness representations, HF self-care behaviors, and healthrelated quality of life (HRQOL). The majority of the sample was male (59%). While most of the participants were Anglo, 12% were African-American and 9% identified themselves as Latino/Hispanic. Participants had been living with their diagnosis for a median time of 3.5 years (M = 6.1 years, SD = 8.12). Each experienced, on average, at least one hospitalization due to HF in the past 12 months (M = 1.1 visits, SD = 2.02) with the median time since admission for the entire group at 1.1 years (M = 2.1 years, SD = 3.13). Approximately 65% of the group were functionally impaired (Class III/IV) according to the Specific Activity Scale (SAS). The average-item Illness Perception Questionnaire-Revised (IPQ-R) scores indicated participants viewed their HF as having serious consequences (M = 3.57, SD = .88) and a chronic course (M = 3.89, SD = 1.03), being under their personal (M = 4.11, SD = .55) and medical (M = 3.65, SD = .63) control but still exhibiting cyclical disruptions in their lives (M = 2.84, SD = .90). Respondents were neutral on the internal (M = 2.55, SD = .78) and external (M = 2.44, SD = .59) causal attribution subscales. Scores on the Self-Care of HF Index (SCHFI) did not correlate significantly with the IPQ-R subscales or scores on the Living with HF Questionnaire (LHFQ). Using hierarchical regression, SAS functional classification (Β =9.96, p <.01), identity (Β =2.01, p <.01), and consequences (Β =1.20, p <.01) explained 64% of the total variance in LHFQ scores. SCHFI total scores did not account for a significant increase in the variance of the LHFQ scores. Implications and recommendations for future studies are discussed.