Psychosocial determinants of quality of life in patients with hypertrophic cardiomyopathy
M Lisiak, J Pryszcz, M Wleklik, I UchmanowiczAbstract
Background
Hypertrophic cardiomyopathy (HCM) is a chronic cardiac condition associated with functional limitations and reduced health-related quality of life (QoL). Psychosocial aspects constitute an integral component of long-term care in this population.
Purpose
The objective of the study was to assess health-related quality of life in patients with hypertrophic cardiomyopathy, with a particular focus on its psychosocial determinants.
Methods
A cross-sectional study was conducted among 51 adult patients with hypertrophic cardiomyopathy, diagnosed according to European Society of Cardiology guidelines and treated at a cardiology clinic. Quality of life was assessed using WHOQOL-BREF and EQ-5D-5L questionnaires. Illness acceptance was measured with the Acceptance of Illness Scale (AIS), and adherence to treatment with the Adherence in Chronic Diseases Scale (ACDS). Associations were analysed using Spearman’s rank correlation coefficient.
Results
The study group consisted of 63% men. The most prevalent comorbidities were heart failure (47.1%) and hypertension (45.1%), while Fabry disease was present in 27.5% of participants. The lowest QoL scores were observed in the physical domain (mean 12.25±2.71). Illness acceptance demonstrated strong positive correlations with perceived overall QoL and all WHOQOL-BREF domains, with the strongest association observed in the physical domain (r=0.838, p<0.001). Higher illness acceptance was also strongly associated with EQ-5D-5L index values and self-rated health (r=0.735, p<0.001 and r=0.730, p<0.001, respectively). Treatment adherence demonstrated moderate positive correlations with perceived QoL (r=0.310, p=0.027) and with psychological (r=0.334, p=0.017), social (r=0.413, p=0.003) and environmental (r=0.472, p<0.001) domains of WHOQOL-BREF. Increasing age was negatively associated with physical aspects of QoL (r=−0.400, p=0.004). Similar negative associations were observed between age and EQ-5D-5L index values and self-rated health (r=−0.328, p=0.019 and r=−0.358, p=0.010, respectively). No significant associations were found between QoL and sex or place of residence.
Conclusions
Psychosocial factors, particularly illness acceptance and adherence to treatment, were strongly associated with quality of life in patients with hypertrophic cardiomyopathy. These findings emphasise the clinical relevance of routine psychosocial assessment and support as integral components of chronic nursing care focused on patient-reported outcomes.