Factors influencing quality of life in older women with heart disease

BACKGROUND. Better understanding of factors influencing the quality of life (QOL) of cardiac patients can guide treatment decisions. OBJECTIVES. TO describe the impact of clinical and psychosocial factors on the QOL of older women with heart disease. RESEARCH DESIGN. Baseline and 12-month data from women participating in an intervention study. SUBJECTS. Eligible participants, identified from medical records, were fema le, greater than or equal to 60 years of age, and diagnosed with cardiac di sease, A volunteer sample of 570 women (87% white) completed baseline inter views, with 485 women completing the 12-month assessment. MEASURES. Utilizing Wilson and Cleary's conceptual framework (1995), measur es of clinical, psychosocial, and functional status were examined for their associations with QOL. RESULTS. At baseline, General Health Perceptions and Symptom Status account ed for 38% and 26%, respectively, of the variation in the QOL rating. Using logistic regression models, seven measures were significant predictors (P <0.05) of maintenance/improvement versus decline in QOL over 12 months: bas eline QOL rating; baseline value and change in satisfaction with social act ivities over 12 months; change in satisfaction with physical activities; ch ange in satisfaction with mental activities; and baseline value and change in perceived stress. For women who maintained or improved their satisfactio n with social activities, the odds for also maintaining or improving QOL we re 4.5 times the odds for women whose satisfaction with social activities d eteriorated. CONCLUSIONS. Satisfaction with social activities and perceived stress are i mportant predictors of subsequent QOL, Consideration of the impact of treat ments on these factors may help to prevent deterioration of QOL among older female cardiac patients.