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Self-reported health and quality of life outcomes of heart failure patients in the aftermath of a national economic crisis: a cross-sectional study

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dc.contributor Háskóli Íslands
dc.contributor University of Iceland
dc.contributor.author Ketilsdóttir, Auður
dc.contributor.author Ingadottir, Brynja
dc.contributor.author Jaarsma, Tiny
dc.date.accessioned 2020-05-19T15:41:09Z
dc.date.available 2020-05-19T15:41:09Z
dc.date.issued 2018-10-18
dc.identifier.citation Ketilsdottir, A., Ingadottir, B., and Jaarsma, T. ( 2019) Self‐reported health and quality of life outcomes of heart failure patients in the aftermath of a national economic crisis: a cross‐sectional study. ESC Heart Failure, 6: 111– 121. https://doi.org/10.1002/ehf2.12369.
dc.identifier.issn 2055-5822
dc.identifier.uri https://hdl.handle.net/20.500.11815/1822
dc.description Publisher's version (útgefin grein)
dc.description.abstract Aims: There are indications that economic crises can affect public health. The aim of this study was to describe characteristics, health status, and socio-economic status of outpatient heart failure (HF) patients several years after a national economic crisis and to assess whether socio-economic factors were associated with patient-reported outcome measures (PROMs). Methods and results: In this cross-sectional survey, PROMs were measured with seven validated instruments, as follows: self-care (the 12-item European Heart Failure Self-Care Behaviour scale), HF-related knowledge (Dutch Heart Failure Knowledge Scale), symptoms (Edmonton Symptom Assessment System), sense of security (Sense of Security in Care—‘Patients' evaluation’), health status (EQ-5D visual analogue scale), health-related quality of life (HRQoL) (Kansas City Cardiomyopathy Questionnaire), and anxiety and depression (Hospital Anxiety and Depression Scale). Additional data were collected on access and use of health care, household income, demographics, and clinical status. The patients' (n = 124, mean age 73 ± 14.9, 69% male) self-care was low for exercising (53%) and weight monitoring (50%) but optimal for taking medication (100%). HF-specific knowledge was high (correct answers 12 out of 15), but only 38% knew what to do when symptoms worsened suddenly. Patients' sense of security was high (>70% had a mean score of 5 or 6, scale 1–6). The most common symptom was tiredness (82%); 12% reported symptoms of anxiety, and 18% had symptoms of depression. Patients rated their overall health (EQ-5D) on average at 65.5 (scale 0–100), and 33% had poor or very bad HRQoL. The monthly income per household was <€3900 for 84% of the patients. A total of 22% had difficulties making appointments with a general practitioner (GP), and 5% had no GP. On average, patients paid for six health care-related items, and >90% paid for medications, primary care, and visits to hospital and private clinics out of their own pocket. The cost of health care had changed for 71% of the patients since the 2008 economic crisis, and increased out-of-pocket costs were most often explained by a greater need for health care services and medication expenses. There was no significant difference in PROMs related to changes in out-of-pocket expenses after the crisis, income, or whether patients lived alone or with others. Conclusions: This Icelandic patient population reported similar health-related outcomes as have been previously reported in international studies. This study indicates that even after a financial crisis, most of the patients have managed to prioritize and protect their health even though a large proportion of patients have a low income, use many health care resources, and have insufficient access to care. It is imperative that access and affordable health care services are secured for this vulnerable patient population.
dc.description.sponsorship This work was supported by Landspítali University Hospital Research Fund, Landspítali, National University Hospital of Iceland; Icelandic Nurses' Association Research Fund; the Maria Finnsdottir Research Fund; and the Heart Failure Association of the ESC Nursing Training Fellowship.
dc.format.extent 111-121
dc.language.iso en
dc.publisher Wiley
dc.relation.ispartofseries ESC Heart Failure;6(1)
dc.rights info:eu-repo/semantics/openAccess
dc.subject Heart failure
dc.subject Knowledge
dc.subject Patient-reported outcome measures
dc.subject Quality of life
dc.subject Self-care
dc.subject Symptoms
dc.subject Hjartabilun
dc.subject Lífsgæði
dc.subject Sjúklingar
dc.subject Efnahagskreppur
dc.subject sjálfs
dc.title Self-reported health and quality of life outcomes of heart failure patients in the aftermath of a national economic crisis: a cross-sectional study
dc.type info:eu-repo/semantics/article
dcterms.license This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
dc.description.version Peer Reviewed
dc.identifier.journal ESC Heart Failure
dc.identifier.doi 10.1002/ehf2.12369
dc.relation.url https://onlinelibrary.wiley.com/doi/full/10.1002/ehf2.12369
dc.contributor.department Hjúkrunarfræðideild (HÍ)
dc.contributor.department Faculty of Nursing (UI)
dc.contributor.school Heilbrigðisvísindasvið (HÍ)
dc.contributor.school School of Health Sciences (UI)

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