The Relationship Between Resilience and Health-Related Quality of Life Among Heart Failure Patients in New York Heart Association Functional Classes II and III

Abstract

ABSTRACT Background Heart failure is an intense, unpredictable, and stressful chronic disease caused by the decline in cardiac pumping function. The influence of heart failure affects patients not only in terms of physical capabilities but also in terms of their emotional and social dimensions, with patients in different functional classes experiencing different levels of effect. Although resilience and health-related quality of life have been studied in populations with heart failure, the scholarly understanding of different functional classes is limited. Purpose This study was designed to investigate the relationship between resilience and health-related quality of life among patients with heart failure in different physical functional classes in Taiwan. Methods A cross-sectional design was applied to study patients with heart failure in northern Taiwan. Two structured questionnaires, including the Resilience Scale for Adults and the 12-item Short Form Health Survey, were used to assess resilience and health-related quality of life. New York Heart Association functional class was used to determine physical function status, and canonical correlation analysis was used to determine the weight of each resilience and quality-of-life domain for the different functional classes. Results The 100 participants had an average age of 65.52 years. Slightly over half (56%) were classified as Functional Class II. A group difference in health-related quality of life was observed. Personal strength (rs = .759) and social competence (rs = −.576) were found to influence the resilience and emotional role dimension of quality of life (rs = −.996) in the Functional Class II group. In addition, family cohesion (rs = −.922), dominant resilience, physical function (rs = .467), and bodily pain (rs = .465) were found to influence quality of life in the Functional Class III group. Conclusions/Implications for Practice The efficacy of measures taken to increase resilience to heart failure varied in patients in different functional classes. Functional Class II individuals were better able to manage the disease using their personal strength, whereas Functional Class III individuals relied more heavily on family support and assistance for this effort. Furthermore, participant feelings about quality of life also varied by functional class, with physical function and bodily pain taking on significantly more importance for Functional Class III individuals.