Study on the Correlation between Continuity of Care and Quality of Life for Patients with Coronary Heart Disease
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Measurement
2.2.1. CHD Patients
2.2.2. Health Status
2.2.3. Patient Continuity of Care Scale
2.2.4. Quality of Life Scale
2.3. Data Collection
2.4. Ethical Considerations
2.5. Statistical Analyses
3. Results
3.1. Overview of CHD Sociodemographic Characteristics, Health Status, Continuity of Care, and Quality of Life
3.2. Correlation between CHD Sociodemographic Characteristics, Health Status, Continuity of Care, and Quality of Life
3.3. Important Predictors of CHD Quality of Life
4. Discussion
4.1. Current Quality of Life of CHD Patients and Status of Continuity of Care
4.2. Factors Affecting Quality of Life of CHD Patients
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
- Roumie, C.L.; Patel, N.J.; Muñoz, D.; Bachmann, J.; Stahl, A.; Case, R.; Leck, C.; Rothman, R.; Kripalani, S. Design and outcomes of the patient centered outcomes research institute coronary heart disease cohort study. Contemp. Clin. Trials Commun. 2018, 10, 42–49. [Google Scholar] [CrossRef] [PubMed]
- American Heart Association (AHA). Coronary Artery Disease. Available online: http://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease/coronary-artery-disease (accessed on 3 October 2019).
- King, M.W.; Bambharoliya, T.; Ramakrishna, H.; Zhang, F. Epidemiology and risk factors. In Coronary Artery Disease and the Evolution of Angioplasty Devices; Springer: Cham, Switzerland, 2020; pp. 1–2. [Google Scholar]
- Maanasa, R. Prevalence and distribution of cardiovascular diseases between Tamil Nadu, India and the United States-A comparative study. Univ. J. Med. Med. Spec. 2019, 5, 1–3. [Google Scholar]
- Assari, S. Cross-country differences in the additive effects of socioeconomics, health behaviors and medical comorbidities on disability among older adults with heart disease. J. Tehran Univ. Heart Cent. 2015, 10, 24. [Google Scholar]
- Griffith, L.E.; Raina, P.; Levasseur, M.; Sohel, N.; Payette, H.; Tuokko, H.; van den Heuvel, E.; Wister, A.; Gilsing, A.; Patterson, C. Functional disability and social participation restriction associated with chronic conditions in middle-aged and older adults. J. Epidemiol. Commun. Health 2017, 71, 381–389. [Google Scholar] [CrossRef] [PubMed]
- Barham, A.; Ibraheem, R.; Sa’ed, H.Z. Cardiac self-efficacy and quality of life in patients with coronary heart disease: A cross-sectional study from Palestine. BMC Cardiovasc. Disord. 2019, 19, 290. [Google Scholar] [CrossRef] [Green Version]
- Palacios, J.E.; Khondoker, M.; Achilla, E.; Tylee, A.; Hotopf, M. A single, one-off measure of depression and anxiety predicts future symptoms, higher healthcare costs, and lower quality of life in coronary heart disease patients: Analysis from a multi-wave, primary care cohort study. PLoS ONE 2016, 11, e0158163. [Google Scholar] [CrossRef] [Green Version]
- Chen, H.M.; Chen, C.M. Factors associated with quality of life among older adults with chronic disease in Taiwan. Int. J. Geriatr. Psychiatry 2017, 11, 12–15. [Google Scholar] [CrossRef] [Green Version]
- Giuliano, C.; Parmenter, B.J.; Baker, M.K.; Mitchell, B.L.; Williams, A.D.; Lyndon, K.; Mair, T.; Maiorana, A.; Smart, N.A.; Levinger, I. Cardiac rehabilitation for patients with coronary artery disease: A practical guide to enhance patient outcomes through continuity of care. Clin. Med. Insights Cardiol. 2017, 11, 1179546817710028. [Google Scholar] [CrossRef] [Green Version]
- Faul, F.; Erdfelder, E.; Buchner, A.; Lang, A.G. Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses. Behav. Res. Methods 2009, 41, 1149–1160. [Google Scholar] [CrossRef] [Green Version]
- Cao, X.Y.; Tian, L.; Chen, L.; Jiang, X.L. Effects of a hospital–community Partnership transitional program in patients with coronary heart disease in Chengdu, China: A randomized controlled trial. Jpn. J. Nurs. Sci. 2017, 14, 320–331. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Shah, S.; Vanclay, F.; Cooper, B. Improving the sensitivity of the Barthel Index for stroke rehabilitation. J. Clin. Epidemiol. 1989, 42, 703–709. [Google Scholar] [CrossRef]
- Chiu, H.C.; Chen, Y.C.; Mau, L.W.; Shiao, S.H.; Liu, H.W.; Huang, M.S. An evaluation of the reliability and validity of the Chinese-version OARS multidimensional functional assessment questionnaire. Chin. J. Public Health 1997, 16, 119–132. [Google Scholar]
- Longevity Foundation Charity Division Promotion Foundation, Japan. Preventive Health Care Referrals Life Function Tests (25 Q) (On line). 2016. Available online: https://www.tyojyu.or.jp/net/check/index.html (accessed on 3 October 2020).
- Hadjistavropoulos, H.; Biem, H.; Sharpe, D.; Bourgault-Fagnou, M.; Janzen, J. Patient perceptions of hospital discharge: Reliability and validity of a patient continuity of care questionnaire. Int. J. Qual. Health Care 2008, 20, 314–323. [Google Scholar] [CrossRef] [PubMed]
- Yao, K.P. Development and applications of the WHOQOL-Taiwan version. Formos. J. Med. 2002, 6, 193–200. [Google Scholar]
- Lee, C.M.Y.; Mnatzaganian, G.; Woodward, M.; Chow, C.K.; Sitas, F.; Robinson, S.; Huxley, R.R. Sex disparities in the management of coronary heart disease in general practices in Australia. Heart 2019, 105, 1898–1904. [Google Scholar] [CrossRef]
- Sciomer, S.; Moscucci, F.; Maffei, S.; Gallina, S.; Mattioli, A. Prevention of cardiovascular risk factors in women: The lifestyle paradox and stereotypes we need to defeat. Eur. J. Prev. Cardiol. 2019, 26, 609–610. [Google Scholar] [CrossRef]
- Gao, Z.; Chen, Z.; Sun, A.; Deng, X. Gender differences in cardiovascular disease. Med. Nov. Technol. Devices 2019, 4, 100025. [Google Scholar] [CrossRef]
- Norris, C.M.; Yip, C.Y.; Nerenberg, K.A.; Clavel, M.A.; Pacheco, C.; Foulds, H.J.; Hardy, M.; Gonsalves, C.A.; Jaffer, S.; Parry, M. State of the science in women’s cardiovascular disease: A Canadian perspective on the influence of sex and gender. J. Am. Heart Assoc. 2020, 9, e015634. [Google Scholar] [CrossRef]
- Backe, I.F.; Patil, G.G.; Nes, R.B.; Clench-Aas, J. The relationship between physical functional limitations, and psychological distress: Considering a possible mediating role of pain, social support and sense of mastery. SSM-Popul. Health 2018, 4, 153–163. [Google Scholar] [CrossRef]
- Uchmanowicz, I.; Lisiak, M.; Wleklik, M.; Gurowiec, P.; Kałużna–Oleksy, M. The relationship between frailty syndrome and quality of life in older patients following acute coronary syndrome. Clin. Interv. Aging 2019, 14, 805. [Google Scholar] [CrossRef] [Green Version]
- Säfström, E.; Nasstrom, L.; Liljeroos, M.; Nordgren, L.; Årestedt, K.; Jaarsma, T.; Stromberg, A. Patient continuity of care questionnaire in a cardiac sample: A confirmatory factor analysis. BMJ Open 2020, 10, e037129. [Google Scholar] [CrossRef] [PubMed]
- Valaker, I.; Fridlund, B.; Wentzel-Larsen, T.; Nordrehaug, J.E.; Rotevatn, S.; Råholm, M.B.; Norekvål, T.M. Continuity of care and its associations with self-reported health, clinical characteristics and follow-up services after percutaneous coronary intervention. BMC Health Serv. Res. 2020, 20, 71. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Su, S.F.; Chang, M.Y.; He, C.P. Social support, unstable angina, and stroke as predictors of depression in patients with coronary heart disease. J. Cardiovasc. Nurs. 2018, 33, 179–186. [Google Scholar] [CrossRef] [PubMed]
- Stahl, S.T.; Beach, S.R.; Musa, D.; Schulz, R. Living alone and depression: The modifying role of the perceived neighborhood environment. Aging Men Health 2017, 21, 1065–1071. [Google Scholar] [CrossRef] [Green Version]
- Ko, H.; Park, Y.H.; Cho, B.; Lim, K.C.; Chang, S.J.; Yi, Y.M.; Noh, E.Y.; Ryu, S.I. Gender differences in health status, quality of life, and community service needs of older adults living alone. Arch. Gerontol. Geriatr. 2019, 83, 239–245. [Google Scholar] [CrossRef]
- Sehrawat, J.S. Assessment of physical and mental health of elderly living alone in Chandigarh: A public health perspective. Indian J. Gerontol. 2019, 33, 61–73. [Google Scholar]
- Hong, M.; De Gagne, J.C.; Shin, H. Social networks, health promoting-behavior, and health-related quality of life in older Korean adults. Nurs. Health Sci. 2018, 20, 79–88. [Google Scholar] [CrossRef]
- Hestevik, C.H.; Molin, M.; Debesay, J.; Bergland, A.; Bye, A. Older persons’ experiences of adapting to daily life at home after hospital discharge: A qualitative metasummary. BMC Health Serv. Res. 2019, 19, 224. [Google Scholar] [CrossRef]
- Hsu, H.C.; Chen, C.F. LTC 2.0: The 2017 reform of home-and community-based long-term care in Taiwan. Health Policy 2019, 123, 912–916. [Google Scholar] [CrossRef]
- Kang, K.; Gholizadeh, L.; Inglis, S.C.; Han, H.R. Correlates of health-related quality of life in patients with myocardial infarction: A literature review. Int. J. Nurs. Stud. 2017, 73, 1–16. [Google Scholar] [CrossRef]
Variables | N | % | |
---|---|---|---|
Sociodemographic Characteristics | |||
Age | <65 >65 | 52 111 | 31.9 68.1 |
Mean (SD) | 69.69 (13.62) | ||
Gender | Male | 88 | 54 |
Female | 75 | 46 | |
BMI (kg/m2) | Mean (SD) 25.60 (4.06) | ||
<18.5 | 1 | 0.6 | |
18.5 ≤ BMI < 24 | 56 | 34.4 | |
24 ≤ BMI < 27 | 60 | 36.8 | |
27 ≤ BMI < 30 | 33 | 20.2 | |
30 ≤ BMI < 35 | 11 | 6.7 | |
≥35 | 2 | 1.2 | |
Marital status | Single (unmarried/divorced/widowed) | 61 | 37.4 |
Spouse (married/cohabiting, separated) | 102 | 62.6 | |
Living situation | Solitary | 33 | 20.2 |
Not alone | 130 | 79.8 | |
Number of people living in household | 0 | 33 | 20.2 |
<3 | 76 | 46.7 | |
>3 | 54 | 33.1 | |
Mean (SD) | 2.61 (1.99) | ||
Persons living with | Spouse | 85 | 52.1 |
Children | 90 | 55.2 | |
Grandchildren/parents/brothers and sisters/friends/foreign domestic helpers | 60 | 36.8 | |
Religion | No | 35 | 21.5 |
Yes | 128 | 78.5 | |
Level of education | Illiterate/literate (self-study)/primary | 83 | 50.9 |
Junior high school/junior/high school (vocational) | 53 | 32.5 | |
Junior college and above | 27 | 16.6 | |
Employment status | Unemployed | 113 | 69.3 |
Employed | 50 | 30.7 | |
Income | Sufficient/more than sufficient | 27 | 16.6 |
Roughly enough | 98 | 60.1 | |
Slightly insufficient/inadequate | 38 | 23.3 | |
Main source of income | Children/spouse/brothers or sisters/parents | 96 | 85.9 |
Pension/ government grants | 36 | 22.1 | |
Employment | 31 | 19.0 | |
Discharge trend | Go home | 158 | 96 |
Transfer to acute/chronic ward | 5 | 3.1 | |
Health status | |||
Number of diseases | <3 | 82 | 50.3 |
3–5 | 68 | 41.7 | |
6 and above | 13 | 8.0 | |
Mean (SD) | 3.5 (1.37) | ||
Time since diagnosis | <1 year | 46 | 28.2 |
1–5 years | 53 | 32.5 | |
6 years and above | 64 | 39.3 | |
Smoking habit | Without | 110 | 67.5 |
With | 53 | 32.5 | |
Frequency of weekly exercise | Never | 45 | 27.6 |
<3 times a week | 85 | 52.1 | |
>3 times a week | 33 | 20.2 | |
Treatment method | Cardiac catheterization | 95 | 58.3 |
Angioplasty and vascular stenting | 63 | 38.7 | |
Coronary artery bypass graft | 5 | 3.1 | |
Phase−1 cardiac rehabilitation | Without | 119 | 73 |
With | 44 | 27 | |
ADL | Mean (SD) 84.88 (25.62) | ||
IADL | Mean (SD) 18.62 (7.59) |
Variables | Mean Score (SD) | Mean/Item(SD) | Score Indicator |
WHOQOL–BREF Taiwan Version Total QoL score (16–80) | 56.56 (11.74) | 3.54 (0.73) | 70.70 |
Physiological health domain (4–20) | 13.13 (2.80) | 3.28 (0.70) | 65.65 |
Psychological health domain (4–20) | 13.72 (3.48) | 3.43 (0.87) | 68.60 |
Social relationships domain (4–20) | 15.02 (3.13) | 3.75 (0.78) | 75.10 |
Environment domain (4–20) | 14.70 (3.14) | 3.67 (0.78) | 73.50 |
PCCQ | |||
Total score of PCCQ (12–60) | 51.80 (6.04) | 4.32 (0.50) | 86.33 |
Relationships with providers during hospitalization (5–25) | 21.61 (2.63) | 4.32 (0.53) | 86.44 |
Information transfer to patients (7–35) | 30.18 (3.71) | 4.31 (0.53) | 86.23 |
Variables | Mean Score (SD) | n | % |
Coronary heart disease risk of disability (24) | 9.36 (6.23) | ||
Movement (5) | 1.98 (1.63) | 122 | 74.8 |
Nutrition (4) | 1.86 (1.52) | 121 | 74.2 |
Cognition (5) | 1.85 (1.45) | 124 | 76.1 |
Sociability (5) | 1.37 (1.86) | 72 | 44.2 |
Depression (5) | 2.31 (2.09) | 112 | 68.7 |
Variables | Physiological Health | Psychological | Social | Environment |
---|---|---|---|---|
Gender a | t = 0.539 | t = 1.871 | t = 1.799 | t = 0.862 |
Marital status a | t = 1.470 | t = 1.776 | t = 0.923 | t = 2.754 ** |
① Single(unmarried/divorced/widowed) | ||||
② Spouse (married/cohabiting, separated) | ||||
Living situation a | t = 6.442 *** | t = 4.682 *** | t = 4.568 *** | t = 3.504 *** |
① Solitary | ||||
② Not alone | ||||
Religion a | t = 2.943 ** | t = 2.596 * | t = 1.987 * | t = 1.452 |
① Without | ||||
② With | ||||
Employment status a | t = −2.219 * | t = −1.374 | t = −2.960 ** | t = −0.481 |
① Unemployed | ||||
② Employed | ||||
Discharge trend a | t = 1.383 ** | t = 2.924 ** | t = 2.518 * | t = 2.190 * |
① Go home ② Transfer to acute/chronic ward | ||||
Smoking habit a | t = −3.354 ** | t = −3.066 ** | t = −2.608 ** | t = −1.178 |
① Without ② With | ||||
Level of education b | F = 7.553 *** | F = 6.676 ** | F = 4.862 ** | F = 2.950 |
① Illiterate/literate (self- study)/Primary | ||||
② Junior high school/junior/high school (vocational) | ||||
③ Junior college and above | ③ > ① | ③ > ① | ||
Scheffe post-comparison | ③ > ② | ③ > ② | ③ > ② | |
Main source of income b | F = 1.329 | F = 2.055 | F = 3.125* | F = 2.236 |
① Children/spouse/brothers or sisters/parents | ||||
② Pension/government grants | ||||
③ Employment | ||||
Scheffe post-comparison | ① > ② | |||
Age | r = 0.137 | r = 0.175 * | r = 0.262 ** | r = 0.231 ** |
Number of people living in household | r = −0.249 *** | r = −0.246 ** | r = −0.212 ** | r = −0.179 * |
ADL | r = 0.381 *** | r = 0.355 *** | r =0.298 *** | r =0.240 ** |
IADL | r = 0.521 *** | r = 0.522 *** | r =0.451 *** | r =0.516 *** |
Risk of disability | ||||
Overall | r = −0.081 | r = −0.049 | r = −0.040 | r = −0.067 |
Movement | r = −0.263 *** | r = −0.248 *** | r = −0.224 ** | r = −0.156 * |
Nutrition | r = −0.204 ** | r = −0.233 ** | r = −0.211 ** | r = −0.185 * |
Cognition | r = −0.028 | r = −0.035 | r = −0.012 | r = −0.009 |
Sociability | r = −0.448 *** | r = −0.467 *** | r = −0.358 *** | r = −0.341 *** |
Depression | r = −0.218 *** | r = −0.221 ** | r = −0.183 * | r = −0.175 * |
PCCQ | ||||
Overall | r = 0.329 *** | r = 0.421 *** | r = 0.421 *** | r = 0.359 *** |
Relationships with providers during hospitalization | r = 0.321 *** | r = 0.399 *** | r = 0.417 *** | r = 0.346 *** |
Information transfer to Patients | r = 0.308 *** | r = 0.402 *** | r = 0.390 *** | r = 0.399 *** |
Variables | QoL | ||||||
---|---|---|---|---|---|---|---|
B | SE | Beta | Adjust R2 | t | 95%CI | p | |
Age | 0.281 | 0.054 | 0.307 | 0.181 | 5.247 | (0.175, 0.387) | 0.001 *** |
Living situation | −7.086 | 1.877 | −0.299 | 0.07 | −3.775 | (−3.378, −1.794) | 0.001 *** |
Main source of income | |||||||
Pension/government grants | −4.210 | 1.526 | −0.140 | 0.018 | −2.758 | (−7.224, −1.195) | 0.007 ** |
Children/spouse/brothers or sisters/parents (reference group) | |||||||
Health status | |||||||
IADL | 0.923 | 0.098 | 0.562 | 0.261 | 9.378 | (0.729, 1.117) | 0.001 *** |
Risk of disability | |||||||
Depression | −0.725 | 0.354 | −0.122 | 0.009 | −2.048 | (−1.424, −0.026) | 0.042 * |
PCCQ | |||||||
Information transfer to patients | 0.752 | 0.179 | 0.244 | 0.048 | 4.212 | (0.399, 1.105) | 0.001 *** |
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Pai, H.-C.; Hu, Y.-F.; Chao, S.-Y.; Chen, H.-M. Study on the Correlation between Continuity of Care and Quality of Life for Patients with Coronary Heart Disease. Int. J. Environ. Res. Public Health 2020, 17, 9125. https://doi.org/10.3390/ijerph17239125
Pai H-C, Hu Y-F, Chao S-Y, Chen H-M. Study on the Correlation between Continuity of Care and Quality of Life for Patients with Coronary Heart Disease. International Journal of Environmental Research and Public Health. 2020; 17(23):9125. https://doi.org/10.3390/ijerph17239125
Chicago/Turabian StylePai, Hsiang-Chu, Yi-Fang Hu, Shu-Yuan Chao, and Hsiao-Mei Chen. 2020. "Study on the Correlation between Continuity of Care and Quality of Life for Patients with Coronary Heart Disease" International Journal of Environmental Research and Public Health 17, no. 23: 9125. https://doi.org/10.3390/ijerph17239125
APA StylePai, H. -C., Hu, Y. -F., Chao, S. -Y., & Chen, H. -M. (2020). Study on the Correlation between Continuity of Care and Quality of Life for Patients with Coronary Heart Disease. International Journal of Environmental Research and Public Health, 17(23), 9125. https://doi.org/10.3390/ijerph17239125