Quality of life among patients with atrial fibrillation

<b>Abstract</b><br/><p><strong><span lang="EN-US">Background</span></strong></p> <p><span lang="EN-US">Patients with atrial fibrillation (AF) have significantly lower health-related quality of life (HRQoL) compared to the general population and patients with other heart diseases. The research emphasis on the influence of AF symptoms on HRQoL overshadows the role of individual characteristics. To address this gap, this study’s purpose was to </span><span lang="EN-US">test an incremental predictive model </span><span lang="EN-US">for AF-related HRQoL following an adapted HRQoL conceptual model that incorporates both symptoms and individual characteristics.</span></p> <p><strong><span lang="EN-US">Methods</span></strong></p> <p><span lang="EN-US">Patients attending an AF specialty clinic were invited to complete an online survey. Hierarchical regression analyses were conducted to examine whether individual characteristics (overall mental health, perceived stress, sex, age, AF knowledge, household and recreational physical activity) incremented prediction of HRQoL and AF treatment satisfaction beyond AF symptom recency and overall health. </span></p> <p><strong><span lang="EN-US">Results</span></strong></p> <p>Of 196 participants (mean age 65.3 years), 63% were male and 90% were Caucasian. Most reported ‘excellent’ or ‘good’ overall and mental health, had high overall AF knowledge scores, had <span lang="EN-US">low </span>perceived stress scores, and had high household and recreation physical activity. The mean overall AF Effect On Quality-Of-Life Questionnaire (<span lang="EN-US">AFEQT) and AF treatment satisfaction scores were 70.62 and 73.84, respectively. Recency of </span><span lang="EN-US">AF symptoms and overall health accounted for 29.6% of the variance in overall HRQoL and 20.2% of the variance in AF treatment satisfaction. Individual characteristics explained an additional 13.6% of the variance in overall HRQoL and 7.6% of the variance in AF treatment satisfaction. Perceived stress and household physical activity were the largest contributors to overall HRQoL, whereas age and AF knowledge made significant contributions to AF treatment satisfaction.</span></p> <p><strong><span lang="EN-US">Conclusions</span></strong></p> <p><span lang="EN-US">Along with AF symptoms and overall health, individual characteristics are important predictors of HRQoL and AF treatment satisfaction in AF patients. In particular, perceived stress and household physical activity </span><span lang="EN-US">could further be targeted as potential areas to improve HRQoL. </span></p>

**摘要**
### 背景
心房颤动（atrial fibrillation, AF）患者的健康相关生活质量（health-related quality of life, HRQoL）显著低于普通人群及其他心脏病患者。当前研究多聚焦于AF症状对HRQoL的影响，却忽视了个体特征的作用。为填补这一研究空白，本研究基于整合了症状与个体特征的改良HRQoL概念模型，构建并检验了AF相关HRQoL的增量预测模型。
### 方法
本研究邀请前往AF专科门诊的患者参与在线问卷调查。采用分层回归分析，检验在纳入AF症状近期发作情况与总体健康状况的基础上，个体特征（总体心理健康状况、感知压力、性别、年龄、AF认知水平、居家及休闲体育运动）是否能够提升HRQoL与AF治疗满意度的预测效能。
### 结果
本研究共纳入196名参与者，平均年龄为65.3岁，其中63%为男性，90%为白人。多数参与者自评总体健康与心理健康状况为“优秀”或“良好”，AF认知水平得分较高，感知压力得分较低，且居家与休闲体育运动量较高。受试者的心房颤动对生活质量影响问卷（Atrial Fibrillation Effect on QualiTy-of-Life Questionnaire, AFEQT）总体得分与AF治疗满意度得分的平均值分别为70.62与73.84。AF症状近期发作情况与总体健康状况可解释总体HRQoL变异的29.6%，以及AF治疗满意度变异的20.2%；个体特征可进一步解释总体HRQoL变异的13.6%，以及AF治疗满意度变异的7.6%。其中，感知压力与居家体育运动是影响总体HRQoL的最主要因素，而年龄与AF认知水平则对AF治疗满意度具有显著预测作用。
### 结论
研究结果表明，除AF症状与总体健康状况外，个体特征同样是AF患者HRQoL与AF治疗满意度的重要预测因子。尤其值得注意的是，感知压力与居家体育运动可作为改善AF患者HRQoL的潜在干预靶点。