Quality of life
Patterns and Predictors of Quality of Life at 5 to 10 Years After Heart Transplantation

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Background

Although studies have provided us with a cross-sectional analysis of long-term quality of life (QOL) after transplantation, relatively few longitudinal studies have been done that allow us to understand changes in QOL over time. The purposes of our study were to describe QOL over time and identify predictors of QOL longitudinally from 5 to 10 years after heart transplantation.

Methods

All 555 subjects enrolled in this study completed booklets of questionnaires. These patients had a mean age of approximately 54 years (range 21 to 75 years) at time of transplant. Seventy-eight percent were men and 88% were white. Participants completed nine self-report QOL instruments for this study. Statistical analyses included frequencies, means ± standard deviations (plotted over time), Pearson correlation coefficients and multiple regression coupled with repeated measures.

Results

At 5 to 10 years after heart transplantation, recipients reported high levels of satisfaction with overall QOL and with health-related QOL, which was stable over the 5-year period. Predictors of satisfaction with overall QOL (that individually accounted for 1% variance or more) were primarily psychosocial variables (overall model explaining 71% of variance), whereas predictors of satisfaction with QOL related to health and functioning (that also explained ≥1% variance) included symptom distress and physical function, as well as psychosocial variables (overall model explaining 72% of variance).

Conclusions

At 5 to 10 years after heart transplantation, QOL remained positive and stable. Bio-psychosocial variables predicted satisfaction with overall QOL and health-related QOL. Understanding of these bio-psychosocial variables provides direction for the development of long-term therapeutic strategies after heart transplantation so that patients can have good post-transplant outcomes.

Section snippets

Sample

Patients who participated in this research were from a large, multi-site, prospective study of QOL outcomes between 5 and 10 years after heart transplantation. The non-random sample for our study was drawn from patients (n = 1,437) transplanted between July 1, 1990 and June 30, 1999 at four medical centers in the USA (Figure 1). There were 884 patients between 5 and 10 years post–heart transplantation who were potentially eligible for recruitment into the study. The 553 patients who were not

Demographic and clinical characteristics

The 555 enrolled patients who completed booklets of questionnaires were approximately 54 years of age at time of transplant (range 21 to 75 years). Of these patients, 78% were men, 88% were white, 79% were married and 59% had more than a high school education (mean 14 ± 2.9 years). Demographic and clinical characteristics of enrolled patients (n = 597) were compared with characteristics of non-enrolled patients who were contacted and met study entry criteria (n = 127) (Table 3). Significant

Discussion

At 5 to 10 years after heart transplantation, recipients reported high levels of satisfaction with overall QOL and with health-related QOL that was stable over the 5-year period. These findings, which are similar to those in other studies of QOL,1, 6, 28, 29, 30 suggest that patients are generally content with their lives long term after heart transplantation. Predictors of satisfaction with QOL included a variety of biopsychosocial variables. At 5 to 10 years after transplantation, predictors

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    Supported by the NIH (National Institute of Nursing Research, R01 NR005200); a grant-in-aid from the College of Nursing, Rush University; and intramural funding from the Rush Heart Institute, Rush University Medical Center.

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