Self-care and quality of life in comorbid patients with chronic coronary syndromes: is there any correlation?

Aim: to assess self-care skills and quality of life in patients with chronic coronary syndromes (CCS). Material and methods: the study involved 100 consecutive patients with stable coronary heart disease (CHD) admitted to cardiology departments. All patients admitted to the clinic underwent standard examination and treatment, taken in the management of patients with CCS. Besides, we assessed socio-demographic properties (marital status, education level, profession, disability for all reasons, income level), quality of life (using SF-36, SAQ questionnaires), levels of anxiety and depression (HADS scale), type D personality (DS-14 questionnaire), treatment adherence (Four-Item Morisky-Green-Levine medication adherence scale), Charlson comorbidity index, The Self Care of Coronary Heart Disease Inventory. Data processing was carried out using descriptive statistics, correlation and variance analysis. results: type D personality was identified in 60 patients (10.2 ± 5.6) on the scale of negative excitability, in 59 people (10.4 ± 3.7) — on the scale of social inhibition. An increased level of anxiety was found in 48 patients (7.6 ± 3.5), depression — in 49 people (7.1 ± 3.4). The average values of the physical component of the quality of life according to the SF-36 questionnaire were 36.9 ± 18.7 and 45.9 ± 19.6 points, respectively. The quality of life associated with exertional angina pectoris, according to the SAQ questionnaire, was 48.8 ± 19.7 points on the scale of limiting physical activity, 49.7 ± 28.2 points for seizure stability, and 70.5 ± 17.8 points for satisfaction with treatment. Treatment adherence according to the Morisky-Green scale was, on average, 2.6 ± 1.2 (Me: 2, [2.4]). Self-care skills on the scale A was 61.3 ± 12.2 points, on the scale B — 49.0 ± 16.2 points, on the scale C — 32.3 ± 14.5 points. In groups of CCS, significant (p <0.05) differences were found on the scales A and B. Significant differences in the self-care skills were obtained among the groups of patients with and without a history of postinfarction cardiosclerosis. Conclusion: the capacity for self-care skills and the quality of life of Russian comorbid patients with CCS is unsatisfactory, which requires active medical intervention and the development of tools for their effective modification.

1. Толпыгина С. Н., Марцевич С. Ю. Исследование ПРОГНОЗ ИБС. Новые данные по отдаленному наблюдению. Профилактическая медицина. 2016;19(1):30-36. doi:10.17116/profmed201619130-36

2. Knuuti J, Wijns W, Saraste A, Capodanno D, Barbato E, FunckBrentano C, et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2020;41(3):407-477. doi: 10.1093/eurheartj/ehz425

3. Российское кардиологическое общество (РКО). Стабильная ишемическая болезнь сердца. Клинические рекомендации 2020. Российский кардиологический журнал. 2020;25(11):4076. doi:10.15829/1560-4071-2020-4076

4. Authors/Task Force Members, Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts): Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur J Prev Cardiol. 2016;23(11):NP1-NP96. DOI: 10.1177/2047487316653709

5. Кабаргина А.И., Лопатин Ю.М. Валидность и надежность русскоязычной версии опросника способности к самопомощи “The Self-Care of Coronary Heart Disease Inventory” при хронических коронарных синдромах. Российский кардиологический журнал. 2020;25(9):3961. Doi: 10.15829/1560-4071-2020-3961

6. Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986;24(1):67-74. doi: 10.1097/00005650-198601000-00007

7. Charlson M, Szatrowski TP, Peterson J, Gold J. Validation of a combined comorbidity index. J Clin Epidemiol. 1994;47(11):1245–51. doi: 10.1016/0895-4356(94)90129-5

8. Ware JE. SF-36 Health Survey update. Spine (Phila Pa 1976). 2000;25(24):3130–9. doi: 10.1097/00007632-200012150-00008

9. Spertus JA, Winder JA, Dewhurst TA, Deyo RA, Prodzinski J, McDonnell M, et al. Development and evaluation of the Seattle Angina questionnaire: A new functional status measure for coronary artery disease. J Am Coll Cardiol. 1995;25(2):333–41. doi: 10.1016/0735-1097(94)00397-9

10. Herrero MJ, Blanch J, Peri JM, De Pablo J, Pintor L, Bulbena A. A validation study of the hospital anxiety and depression scale (HADS) in a Spanish population. Gen Hosp Psychiatry. 2003;25(4):277–83. doi: 10.1016/S0163-8343(03)00043-4

11. O’Dell KR, Masters KS, Spielmans GI, Maisto SA. Does type-D personality predict outcomes among patients with cardiovascular disease? A meta-analytic review. J Psychosom Res. 2011;71(4):199–206. doi: 10.1016/j.jpsychores.2011.01.009

12. Kuodytė L. Sergančiųjų išemine širdies liga savirūpos ir žinių. 2019.

13. Svavarsdóttir MS, Sæmundsdóttir KG, Ingadóttir B. Risk factors and self care of individuals with coronary heart disease: cross sectional study. Tímarit hjúkrunarfræðinga. 2020;96(1):76-83.

14. Riegel B, Lee CS, Dickson VV, Carlson B. An update on the selfcare of heart failure index. J Cardiovasc Nurs. 2009;24(6):485-97. DOI: 10.1097/JCN.0b013e3181b4baa0

15. Silveira LCJ, Rabelo-Silva ER, Ávila CW, Beltrami Moreira L, Dickson VV, Riegel B. Cross-cultural Adaptation of the Selfcare of Hypertension Inventory Into Brazilian Portuguese. J Cardiovasc Nurs. 2018;33(3):289-295. doi: 10.1097/JCN.0000000000000442. PMID: 28731915.

16. Pedersen SS, Middel B. Increased vital exhaustion among type-D patients with ischemic heart disease. J Psychosom Res. 2001;51(2):443-9. doi: 10.1016/s0022-3999(01)00203-3. PMID: 11516767.

17. Denollet J, Pedersen SS, Vrints CJ, Conraads VM. Usefulness of type D personality in predicting five-year cardiac events above and beyond concurrent symptoms of stress in patients with coronary heart disease. Am J Cardiol. 2006;97(7):970-3. DOI: 10.1016/j.amjcard.2005.10.035.

18. Pelle AJ, Denollet J, Zwisler AD, Pedersen SS. Overlap and distinctiveness of psychological risk factors in patients with ischemic heart disease and chronic heart failure: are we there yet? J Affect Disord. 2009;113(1-2):150-6. doi: 10.1016/j.jad.2008.05.017

19. Denollet J, Brutsaert DL. Reducing emotional distress improves prognosis in coronary heart disease: 9-year mortality in a clinical trial of rehabilitation. Circulation. 2001;104(17):2018-23. doi: 10.1161/hc4201.097940. PMID: 11673339.

20. Чазов Е.И., Оганов Р.Г., Погосова Г.В., Деев А.Д., Шалънова С.А., Колтунов И.Е., Ромасенко Л.В. Депрессивная симптоматика ухудшает прогноз у больных артериальной гипертонией и ишемической болезнью сердца: первые результаты проспективного этапа российского многоцентрового исследования КООРДИНАТА. Кардиология. 2007;47(10):24-30. eLIBRARY ID: 21984564

21. Versteeg H, Hoogwegt MT, Hansen TB, Pedersen SS, Zwisler AD, Thygesen LC. Depression, not anxiety, is independently associated with 5-year hospitalizations and mortality in patients with ischemic heart disease. J Psychosom Res. 2013;75(6):518-25. doi: 10.1016/j.jpsychores.2013.10.005

22. Dempster M, Donnelly M. Measuring the health related quality of life of people with ischaemic heart disease. Heart. 2000;83(6):641-4. DOI: 10.1136/heart.83.6.641

23. de Melo Ghisi GL, Oh P, Thomas S, Benetti M. Development and validation of an English version of the Coronary Artery Disease Education Questionnaire (CADE-Q). Eur J Prev Cardiol. 2013;20(2):291-300. doi: 10.1177/2047487312437061