Effect of Psychosocial Interventions on Quality of Life in Patients With Chronic Heart Failure: A Meta-analysis of Randomized Controlled Trials |
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| Authors: | Lampros Samartzis Stavros Dimopoulos Maria Tziongourou Serafim Nanas |
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| Affiliation: | 1. Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, 1st Critical Care Medicine Department, “Evgenidio” Hospital, National and Kapodistrian University of Athens, Athens, Greece;2. Department of Psychiatry, Nicosia Mental Health Services, Nicosia, Cyprus;3. Department of Clinical Psychology, Nicosia Mental Health Services, Nicosia, Cyprus;1. Second Cardiology Department, Attikon University Hospital, Athens, Greece;2. First Cardiology Department, AHEPA University Hospital, Thessaloniki, Greece;3. Department of Anaesthesiology and Critical Care Medicine, Hospital Lariboisière, APHP, Université Paris Diderot Paris 7, U942 Inserm Paris, France;4. Department of Cardiology, Paracelsus Medical Private University (PMU), Salzburg Landeskliniken, Salzburg, Austria;5. Heart Failure and Transplant Unit, Cardiology Department, Hospital Doce de Octubre, Madrid, Spain;6. Cardiology Division and Heart Failure and Transplantation Program, Hospital Espanhol, Salvador, BA, Brazil;7. Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland;1. Department of Social and Welfare Studies, Linköping University, Linköping, Sweden;2. Department of Medicine and Health Sciences, Linköping University, Linköping, Sweden;3. Department of Cardiology, County Council of Östergötland, Linköping, Sweden;4. Heart Failure Unit, Rabin Medical Center, Petah Tikva, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel;5. Cardiovascular Research Centre, Australian Catholic University, Melbourne, Australia;6. School of Nursing and Midwifery, Deakin University, Melbourne, Australia;7. Department of Cardiology, Charité University Hospital, Berlin, Germany;8. Department of Cardiovascular Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan;9. Department of Cardiology & Angiology I, University Heart Center Freiburg-Bad Krozingen, Freiburg, Germany;10. Department of Nursing Science, Charité - Universitätsmedizin Berlin, Germany;11. Unitat d’Insuficiència Cardíaca, Hospital Universitari Germans Trias i Pujol, Badalona, Spain;12. College of Nursing, University of Kentucky, Lexington, KY, USA;13. Clinical Nursing Department, Thai Nguyen University of Medicine and Pharmacy, Thailand;14. Heart Failure Unit/Cardiology Unit/CCU, S.Camillo-Forlanini Hospital, Rome, Italy;15. Cardiology Division, School of Nursing at Federal University of Rio Grande do Sul, Hospital de Clinicas de Porto Alegre, Brazil;p. Walailak University, School of Nursing, Tasala, Nakhon Si Thammarat, Thailand;q. Department of Nursing, Chang Gung University of Science and Technology, Taiwan;r. School of Nursing, Tor Vergata University, Rome, Italy;s. The Chinese University of Hong Kong, Hong Kong;t. University of Pennsylvania School of Nursing , Philadelphia, USA;1. Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia;2. Rollins School of Public Health and School of Nursing, Emory University, Atlanta, Georgia;3. School of Medicine and School of Nursing, Emory University, Atlanta, Georgia;4. Stony Brook University, Stony Brook, New York;1. Department of Cardiology, Angiology and Pulmology, University Hospital Heidelberg, Heidelberg, Germany;2. National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Imperial College, London, United Kingdom;1. Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada;2. St Michael''s Hospital, Toronto, Ontario, Canada;3. University of Alberta, Edmonton, Alberta, Canada;4. University of Waterloo, Waterloo, Ontario, Canada;5. St Mary''s General Hospital, Kitchener, Ontario, Canada;6. Institut de Cardiologie de Montréal, Montreal, Québec, Canada;7. St Boniface General Hospital, Cardiac Sciences Program, Winnipeg, Manitoba, Canada;8. McGill University, Montreal, Québec, Canada;9. Joseph Brant Memorial Hospital, Burlington, Ontario, Canada;10. University of Calgary, Calgary, Alberta, Canada;11. Centre Hospitalier Régional de Lanaudière, Joliette, Québec and Université Laval, Québec, Canada;12. University of Toronto, Toronto, Ontario, Canada;13. QE II Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada;14. Royal Jubilee Hospital, Victoria, British Columbia, Canada;15. Cardiac Sciences Program, St Boniface General Hospital, Winnipeg, Manitoba, Canada;p. Western Ontario, London, Ontario, Canada;q. Penticton, British Columbia, Canada;r. Université de Moncton, Moncton, New Brunswick, Canada;s. Ottawa Heart Institute, Ottawa, Ontario, Canada;t. Hôpital Laval, Sainte-Foy, Québec, Canada;u. Health Sciences Centre, St John''s, Newfoundland, Canada;1. Departamento de Cardiología y Atención Primaria, Organización Sanitaria Integrada Hospital de Galdakao-Comarca Interior, Osakidetza-Servicio Vasco de Salud, Galdácano, Vizcaya, Spain;2. Unidad de Investigación de Atención Primaria, Osakidetza-Servicio Vasco de Salud, Vizcaya, Spain;3. Departamento de Cardiología, Hospital Virgen de la Salud de Toledo, SESCAM-Servicio de Salud de Castilla-La Mancha, Toledo, Spain;4. Departamento de Cardiología, Hospital Parc Salut del Mar, Barcelona, Spain |
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| Abstract: | BackgroundPatients with chronic heart failure (CHF) usually experience poor quality of life (QoL). Psychosocial interventions tend to affect QoL in CHF. The aim of this study was to explore: 1) the effectiveness of psychosocial interventions on patients' QoL; 2) the magnitude of this effect; and 3) factors that appear to moderate the reported effect on QoL.Methods and ResultsMeta-analysis of the data of 1,074 intervention patients and 1,106 control patients from 16 randomized controlled trials (RCTs) that reported QoL measures in treatment and control groups before and after a psychosocial intervention. Subgroup analyses were conducted between: 1) face-to-face versus telephone interventions; 2) interventions that included only patients versus those that included patients and their caregivers; and 3) interventions conducted by a physician and a nurse only, versus those conducted by a multidisciplinary team. Psychosocial interventions improved QoL of CHF patients (standardized mean difference 0.46, confidence interval [CI] 0.19–0.72; P < .001). Face-to-face interventions showed greater QoL improvement compared with telephone interventions (χ2 = 5.73; df = 1; P < .02). Interventions that included caregivers did not appear to be significantly more effective (χ2 = 1.12; df = 1; P > .29). A trend was found for multidisciplinary team approaches being more effective compared with nonmultidisciplinary approaches (χ2 = 1.96; df = 1; P = .16).ConclusionsA significant overall QoL improvement emerged after conducting psychosocial interventions with CHF patients. Interventions based on a face-to-face approach showed greater benefit for patients' QoL compared with telephone-based approaches. No significant advantage was found for interventions conducted by a multidisciplinary team compared with a physician and nurse approach, or for psychosocial interventions which included patients' caregivers compared with patient-only approaches. |
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