ASSESSMENT OF QUALITY-OF-LIFE WITH THE NOTTINGHAM HEALTH PROFILE AMONG WOMEN WITH CORONARY-ARTERY DISEASE

OBJECTIVE: To examine the differences in the health-related quality of life (HRQOL) of Finnish women with coronary artery disease (CAD) (n = 91) in comparison with Finnish men with CAD (n = 189). Healthy women (n = 990) served as a control group. DESIGN: Prospective, cross-sectio nal survey. SETTING: Surgical and medical clinics at the University of Oulu, Finland. PATIENTS: Twenty-one women underwent coronary artery b ypass grafting (CABG), 40 women underwent percutaneous transluminal co ronary angioplasty (PTCA), and 30 women received medication for treatm ent of CAD. The patients in the medication group were taking beta bloc kers (81%), long-acting nitrates (86%), calcium channel blockers (43%) , aspirin (79%), and lipid-lowering drugs (18%). OUTCOME MEASURES: The Nottingham Health Profile (NHP), which consists of six dimensions: en ergy sleep, pain, emotional reactions, social isolation, and physical mobility. Higher mean indexes signify lower HRQOL. INTERVENTION The pa tients referred to CABG and PTCA procedures were interviewed and asked to fill in the questionnaire on the day before the operation. They we re instructed to describe their HRQOL over the preceding 3 months. The patients in the medication group were mailed the NHP questionnaire. R ESULTS: Women with CAD reported significantly poorer HRQOL than age-ma tched women in the healthy sample, as measured by the following dimens ions of the NHP: energy, sleep, pain, emotional reactions, and physica l mobility. This indicates the NHP dimensions affected by CAD among wo men. HRQOL for women with CAD was lower than that of men with CAD. The mean indexes of four of the six NHP dimensions, energy, sleep, emotio nal reactions, and physical mobility were higher for women with CAD th an men with CAD in the two youngest age groups. Social isolation was m ost common in the youngest age group among, both women and men with CA D. In women with CAD, emotional reactions and social isolation were mo st clearly related to demographic characteristics such as traumatic li fe experiences, depression, financial situation, and smoking. CONCLUSI ONS: These findings suggest that the subjective HRQOL should be consid ered along with the clinical severity of the disease in the evaluation of CAD. The findings further shed light on the HRQOL of especially yo ung women with CAD, the female and male patients' referral for treatme nt, and the use of the NHP instrument among patients with CAD.