Preditores de qualidade de vida relacionados à saúde e distância percorrida no teste de caminhada de seis minutos em portadores de insuficiência cardíaca crônica
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2018-09-28
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Universidade Federal de Goiás
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Background: Heart failure (HF) is a multifactorial and multisystemic clinical syndrome, resulting in physical, functional, muscular, respiratory, metabolic and emotional changes that contribute to a decline in functional capacity and worsening of quality of life. Objective: To evaluate the predictive power of sociodemographic, physical-functional, clinical and emotional factors in the quality of life and the distance covered by the six-minute walk test (6MWD) of patients with chronic HF. Methods: a cross-sectional study, carried out with patients with HF, attended at an outpatient clinic. The following instruments were used: sociodemographic and clinical profile card, health-related quality of life (Minnesota Living With Heart Failure Questionnaire - MLHFQ), Beck Depression and Anxiety Inventory (BAI and BDI). For physical-functional assessment, palmar dynamometry, manovacumetry, spirometry, body mass index, modified dyspnea scale from the Medical Research Council (mMRC), six-minute walk test (6MWT), and physical activity level (short IPAQ ). The outcome variables considered were the health-related quality of life (HRQoL) and the distance covered in the 6MWT (6MWD). In order to determine the predictive variables of 6MWD and HRQoL, Multiple Linear Regression (RLM) analysis was used, with stepwise selection of variables and complemented by hierarchical analysis. The level of significance, adopted for the analyzes, was 5% (p <0.05). Results 81 patients with HF, with mean age of 56.7 years, 65.4% were male. (P = 0.001), dyspnea (mMRC) (p = 0.008), forced vital capacity (FVC) (p = 0.002), and depression symptoms (p <0.001) were independent predictors of HRQoL: ) and anxiety (p <0.001) with coefficient of determination (R2) of 0.78. Predictors of 6MWD were: sex (p = 0.001), age (p = 0.004), FVC (p = 0.016) and mMRC (p = 0.001), with determination coefficient (R2) of 0.37.Conclusions: More symptoms of depression, more hospitalizations, more dyspnea on activities of daily living, lower forced vital capacity, more anxiety symptoms and female sex were predictors of poorer quality of life in patients with chronic heart failure. These variables explained, at the same time, 78% of variance. For the distance covered in the six-minute walk test, the following variables were associated with the worst performance: More dyspnea on daily living activities, female gender, older age, and lower forced vital capacity. which, at the same time, accounted for 37% of the variance.
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MORAIS, Elizabeth Rodrigues de. Preditores de qualidade de vida relacionados à saúde e distância percorrida no teste de caminhada de seis minutos em portadores de insuficiência cardíaca crônica. 2018. 153 f. Tese (Doutorado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2018.