Asian Nurs Res.  2023 Dec;17(5):253-258. 10.1016/j.anr.2023.11.003.

The Mediator Role of Meaning in Life in the Life Quality of Patients With Chronic Heart Failure

Affiliations
  • 1Heart Failure Clinical Nurse Specialist, Heart Failure Research Center, Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan, ROC
  • 2Department of Nursing, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan, ROC
  • 3Professor, College of Medicine, Chang Gung University, Taiwan, ROC
  • 4Heart Failure Research Center, Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan, ROC
  • 5Professor, College of Nursing, National Yang Ming Chiao Tung University, Taiwan, ROC

Abstract

Purpose
Heart failure (HF) is a highly recurrent disease with a high sudden death rate and a substantial influence on disease-related quality of life (QOL). Social support, symptom distress, care needs, and meaning in life all have significant impacts on QOL. We hypothesized that meaning in life plays a mediating role in the relationship of social support, symptom distress, and care needs with QOL among patients with chronic HF.
Methods
Based on cross-sectional analysis, we recruited 186 HF outpatients who completed structured questionnaires for social support, symptom distress, care needs, meaning in life, and QOL. Structural equation modeling was used to analyze the mediating role of meaning in life in the relationship of social support, symptom distress, and care needs with QOL.
Results
The final model showed good model fit. Meaning in life was associated with global QOL (β = 0.18, p = .032). Although symptom distress (β = −0.26, p = .005) and care needs (β = −0.36, p = .021) were negatively associated with global QOL, meaning in life played a partial mediating role between symptom distress and global QOL (β = −0.02, p = .023) and between care needs and global QOL (β = −0.07, p = .030). However, meaning in life played a complete mediating role between social support and global QOL (β = 0.08, p = .047). The model showed that meaning in life, symptom distress, and care needs explained 50% of global QOL.
Conclusions
In patients with chronic HF, meaning in life played a mediating role in the relationship of social support, symptom distress, and care needs with QOL. Implementing an intervention to enrich meaning in life may help patients manage the issues caused by symptoms and alleviate their unmet needs.

Keyword

heart failure; outpatients; quality of life; value of life
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