Acceptance of heart failure improves patients’ quality of life

People who learn they have heart failure often feel emotionally devastated, but new research suggests that accepting the reality of the disease can make life easier.

Researchers in Poland found that people who were able to adapt to their illness reported much more energy, less pain, a brighter outlook and better sleep than those who couldn’t accept their illness. They were also less isolated and more active.

Accepting the illness and having a positive attitude may help the patient cope with the negative emotions, diagnosis and treatment, said the study’s lead author, Monika Obieglo, a nurse at Wroclaw Medical University.

Heart failure patients often feel helpless and hopeless, which can make dealing with their illness more difficult, she told Reuters Health in an email.

More than 23 million adults worldwide have heart failure, including 5.8 million in the U.S. and close to 1 million in Poland, Obieglo and her colleagues write in the European Journal of Cardiovascular Nursing.

A failing heart can't pump enough blood to other parts of the body. As a result, patients may feel short of breath, fatigued and weak, and they may have difficulty concentrating, among other symptoms. Only about 50 percent survive more than five years after diagnosis.

The present study involved 100 patients (68 men and 32 women) being treated by the university’s cardiology department in 2012 and 2013.

The patients, whose average age was 63 and who had heart failure for at least six months, answered questionnaires about their energy levels, pain, emotional reactions, sleep, social isolation and mobility. They also reported on how much the illness was affecting their work, socializing and sex lives.

Overall, those who were older than 60 tended to be more isolated socially, less physically mobile and to feel worse emotionally. Women reported less energy and mobility than men. And people who were heavier also had much more pain than others.

When the researchers compared patients’ acceptance levels with their symptoms and quality of life responses, they found that people who scored higher for acceptance of their illness had a much better quality of life.

Indeed, acceptance was the only independent predictor of quality of life, according to the results.

Dr. Burhan Mohamedali, a cardiologist at Rush University Medical Center in Chicago, said the study added important information about heart failure patients’ ability to weather difficult symptoms.

“Clinically, I completely believe and agree with this paper . . . people who are accepting of their disease do tend to do much better in my clinic compared to people who are fighting their disease,” Mohamedali told Reuters Health.

He was especially interested in the effects of social isolation on patients and their symptoms.

“This is beautiful, it just adds on to more of what I was thinking about. The paper definitely answers some of those questions,” said Mohamedali, who was not involved in the study.

Obieglo said education about heart failure, its symptoms and treatment can help patients come to grips with their illness. They need to see not just heart doctors, but also psychologists, physiotherapists and dietitians, she added.

The report notes that patients who came to terms with their illness were more likely to feel better emotionally and to follow medical recommendations.

The study could well be used as a model for other chronic diseases too, noted Mohamedali, although more research is needed.