ASSESSMENT OF QUALITY-OF-LIFE WITH THE NOTTINGHAM HEALTH PROFILE AMONG PATIENTS WITH CORONARY-HEART-DISEASE

The aim was to describe the quality of life of people suffering from c oronary artery disease. The patients had been treated with medication (n = 80), percutaneous transluminal coronary angioplasty (n = 100) and coronary artery bypass surgery (n = 100). Of the 280 patients, 189 we re men and 91 women. The patients who participated in this study were seriously ill, as nearly half of them had three or more stenosed coron ary arteries. Male patients were most numerous in the bypass surgery g roup and female patients in the angioplasty group. The quality of life was evaluated using the Nottingham Health Profile (NHP) instrument re lation to an age- and sex-matched general population, the background f actors and the severity of the coronary disease. The NHP questionnaire consists of 38 statements on health problems, making up six dimension s of subjective health: physical mobility, pain, sleep, energy, emotio nal reactions and social isolation. The health-related quality of life of coronary patients before the invasive procedures was significantly poorer on all the six dimensions than the quality of life in an age- and sex-matched general population. The most obvious differences were seen on the following dimensions: energy, pain, emotional reactions, s leep and physical mobility. The smallest differences occurred in socia l isolation. Both males and females had the lowest Value for energy an d social isolation in the youngest age group (35-54 years). The index values of emotional reactions in the two youngest groups were signific antly higher among females than males, which reflects poor quality of life. The women in the age group of 35-54 years found the manifestatio n of a serious disease extremely hard to face. Our findings clearly su ggest that while choosing the mode of treatment, the patient's quality of life should be considered along with the clinical severity of the disease, especially in the case of young women. From the societal and social points of view, the patient's symptoms and quality of life are even more important than the objective medical outcome. In clinical de cision-making, the goal is to integrate the results of health-related quality of life assessments with clinical decisions, and this underlin es the need to evaluate whether the treatment given is congruent with the patient's quality of life, On the basis of the present findings, t he NHP instrument seems to be applicable to quality of life measuremen ts among coronary patients, It does not, however, necessarily give an accurate and profound view of an individual's overall quality of life.