The Analysis of the Relationship between the Quality of Life Level and Expectations of Patients with Cardiovascular Diseases under the Home Care of Primary Care Nurses

Abstract

The World Health Organization defines quality of life as a person’s perception of his or her life situation in relation to the culture and value system in which he or she lives, in relation to and with respect to his or her functioning assumptions, expectations, and standards set by environmental conditions. Meeting the expectations of patients with CVD is one of the factors that positively influences their health status and leads to better diagnostic and treatment outcomes. The aim of this study was to answer three main questions related to patients with chronic cardiovascular disease: (1) What is their quality of life? (2) Are patients’ expectations about the quality of care provided by primary health care physicians/nurses met (and at what level)? (3) Is there a correlation between patients’ quality of life and their expectations of primary health care physicians/nurses? The study involved 193 Polish CVD patients who were cared for at home by a family nurse practitioner working in primary health care facilities. Data were collected from March 2016 to January 2017. The WHOQOL-BREF Quality of Life Questionnaire and the Author Interview Questionnaire were used for the study. Data analysis was based on the Spearman correlation coefficient test. There was a statistically significant association between patients’ expectations of the physician regarding information about the course of the disease and quality of life in the following domains: environmental r = 0.20, p = 0.006, psychological: r = 0.18, p = 0.015, physical: r = 0.18, p = 0.013, and social: r = 0.16, p = 0.025. Patients who did not expect the nurse to be courteous, understanding, or interested were found to have higher quality of life scores in psychological (r = −0.17, p = 0.023) and physical (r = −0.15, p = 0.044) domains. There was a statistically significant relationship between expectations of care from nurses regarding intimacy during care activities and the level of satisfaction with one’s own health (r = −0.15, p = 0.038) and quality of life (r = −0.14, p = 0.045), as well as quality of life in the domains of physical (r = 0.21, p = 0.004), social (r = 0.19, p = 0.010), and psychological (r = 0.16, p = 0.024). There is a need to define the expectations of patients with chronic cardiovascular disease in primary care, as lack of expectations of a physician/nurse continues to be associated with lower quality of life in all domains.