The Correlation Between Acceptance of Illness and Medication Adherence and Quality of Life in Patients with Heart Failure referred to Medical Education Center Shahid Madani of Tabriz in 2019.
Sadeghi Azar, Saman
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Abstract: Introduction: Heart failure (13) is the most common cardiovascular disease and is a chronic, progressive and debilitating disorder. It has a negative impact on different aspects of patients' lives and reduces the quality of life in these patients. On the other hand, the disease does not have any definitive treatment and requires adherence to the drug regimen and lifelong care. In addition, various studies have shown that medication adherence requires disease acceptance. Therefore, this study aimed to investigate the relationship between acceptance of illness, adherence to medication, and quality of life in patients with chronic heart failure referred to Shahid Madani teaching hospital of Tabriz in 2019. Methods: The present study was a descriptive-correlational study with the participation of 273 patients with chronic heart failure who were selected by non-random sampling method. Inclusion criteria included having at least 18 years of age, ability to use drugs independently, having physical-mental ability and informed consent to participate in the study, having heart failure classes 2, 3 and 4 according to NYHA classification, no physical and psychiatric disorders, no incurable diseases, no perform of cardiac procedures (e.g. angioplasty, coronary artery bypass grafting and valve replacement) in the past year, and exclusion criteria were non-response to more than 20% of items, and dissatisfaction to continue cooperation in the study. Demographic information checklist, acceptance of illness scale, medication adherence report scale (MARS), and Minnesota living with heart failure questionnaire (MLHFQ) were used for data collection. Data were analyzed by SPSS software version 21 using descriptive and inferential statistics (t-test, one-way ANOVA, Pearson/ Spearman correlation coefficient, and linear regression). Results: In this study, 273 heart failure patients with a mean age of 64.81±14.01 participated. The majority of participating in this study were female (51.92%), single (72.16%), illiterate (49.45), housewife (41.4%), and resident of the city (81.68%). In addition, most of these patients had a history of previous hospitalization (86.45%), no history of smoking (64.83%), no alcohol consumption (95.6%) and no drug uses (95.6%). Also, the most common underlying diseases among these patients were hypertension (76.92%) and the most commonly used drugs include diuretics (78.02%), anticoagulants (72.52%) and beta-blockers (63%). The mean and standard deviation of quality of life, illness acceptance and adherence to the medication were 53.81± 17 17.99 (from the achievable range of 0 - 105), 24.09±6 6.79 (from the achievable range of 8 - 40) and 3.44 ± 3.15 (from the achievable range of 0 - 10), respectively. 66.9% of these patients did not follow the required dietary regimen. Also, 50% of patients had moderate disease acceptance. The results of correlation tests showed that the quality of life had a statistically significant negative association with disease acceptance (r = -0.699, p = 0.000) and a positive statistical relationship with medication adherence (r = 0.296, p = 0.000). There was also a significant positive correlation between disease acceptance and adherence to medication (r = 0.375, p = 0.000). The results of linear regression showed that the acceptance of the disease had a significant effect on quality of life and could predict it. Conclusion: The results of this study showed a moderate disease acceptance, non-adherence to medication and a low quality of life in these patients. In addition, the quality of life in these patients is associated with factors such as disease acceptance and adherence to the medication, so it can be improved through controlling effective factors on disease acceptance and adherence to the medication regimen, as well as through strategies such as education and counseling.