Trajectory of Meaning in Life After Heart Failure Hospitalization is Associated With Quality of Life
Abstract
Background and objective: Patients with heart failure (HF) are at a high risk of sudden death and have poor health-related quality of life (QOL). The uncertainty of living substantially challenges the presence of their meaning in life (MiL). Previous studies suggest that the presence of a strong MiL has a protective effect for patients to face this incurable disease and help them improve their QOL. We hypothesized that characterizing the trajectories of MiL can help identify the patients at the high risk of developing poor QOL for early therapeutic interventions.
Methods: We prospectively enrolled 200 patients with HF hospitalization. From discharge to 6 months after discharge, we interviewed these patients with questionnaires for MiL and QOL at four time points (before discharge and at 1, 3 and 6 months after discharge). Based on these questionnaire of MiL, we used group-based trajectory modeling to identify and define different trajectories of MiL. We characterized patients with different trajectories and further analyzed the independent variables associated with QOL.
Results: We identified three trajectories of MiL: "poor " (8.0%), " moderate " (59%), and "strong" (33%). Compared to patients with a strong MiL, patients with a poor or moderate MiL were older, and had lower education level, worse NYHA functional classes, and poorer social support (all p<0.05); had a higher incidence of being divorced, living alone, dependent economic status, and chronic kidney disease (all p<0.05). With respect to physical component of QOL, the physical component scores (PCS) in patients with poor MiL trajectory were significantly lower than those with moderate (p=0.015) and strong (p<0.001) MiL trajectories. With respect to mental component of QOL, the mental component scores (MCS) in patients with poor MiL trajectory were also significantly lower than those with strong MiL. The factors associated with a better QOL included younger (PCS: B=0.21, p<.001), no chronic kidney disease (PCS: B=7.59, p<.001; MCS: B=4.71, p<.001), and stronger MiL (PCS: B=5.30, p<.001; MCS: B=4.71, p=.004). All these factors could explain 53% of the PCS and 32% of MCS.
Conclusion: During the 6 months after discharge from HF hospitalization, one third of patients develop a strong MiL. The elderly and patients with chronic kidney disease are at high risk of developing poor MiL. It is to be investigated whether an early spiritual intervention for these patients can improve their QOL.
Notes
References:
Czekierda, K., Zarychta, K., Knoll, N., Keller, J., Luszczynska, A. (2019). Links between meaning in life and physical quality of life after rehabilitation: Mediating effects of positive experiences with physical exercises and mobility. PLoS One, 14(10): e0224503. doi: 10.1371/journal.pone.0224503. eCollection 2019.
Marco, J., Castejón , J., Isern, C., Grau, L., Rodríguez, S. P. (2023). Longitudinal evolution of meaning in life and its relationship with coping strategies in Spanish patients with a breast cancer diagnosis. Support Care Cancer, 31(7), 424.
doi: 10.1007/s00520-023-07885-2.
Sun, M., Tian, X., Peng, Y., Wang, Z., Lu, Y., & Xiao, W. (2024). Effects of meaning therapy on spirituality, psychological health, and quality of life in patients with cancer: A systematic review and meta-analysis of randomized controlled trials. Asia Pacific Journal of Oncology Nursing, 11(4):100388. doi: 10.1016/j.apjon.2024.100388. eCollection 2024 Apr.
Wang, S., Zhu, Y., Wang, Z., Zheng, M., Li, X, Zhang, Y., & Wan, H. (2023). Efficacy of meaning-centered group psychotherapy in Chinese patients with cancer: A randomized controlled trial. Palliative & Support Care, 21(5), 773-781. doi: 10.1017/S1478951523000998.
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Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Sub-acute Care, Stress and Coping, Primary Care, Heart Failure, Quality of Life
Recommended Citation
Liu, Min Hui; Wang, Chao-Hung; and Chiou, Ai-Fu, "Trajectory of Meaning in Life After Heart Failure Hospitalization is Associated With Quality of Life" (2025). International Nursing Research Congress (INRC). 96.
https://www.sigmarepository.org/inrc/2025/posters_2025/96
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Trajectory of Meaning in Life After Heart Failure Hospitalization is Associated With Quality of Life
Seattle, Washington, USA
Background and objective: Patients with heart failure (HF) are at a high risk of sudden death and have poor health-related quality of life (QOL). The uncertainty of living substantially challenges the presence of their meaning in life (MiL). Previous studies suggest that the presence of a strong MiL has a protective effect for patients to face this incurable disease and help them improve their QOL. We hypothesized that characterizing the trajectories of MiL can help identify the patients at the high risk of developing poor QOL for early therapeutic interventions.
Methods: We prospectively enrolled 200 patients with HF hospitalization. From discharge to 6 months after discharge, we interviewed these patients with questionnaires for MiL and QOL at four time points (before discharge and at 1, 3 and 6 months after discharge). Based on these questionnaire of MiL, we used group-based trajectory modeling to identify and define different trajectories of MiL. We characterized patients with different trajectories and further analyzed the independent variables associated with QOL.
Results: We identified three trajectories of MiL: "poor " (8.0%), " moderate " (59%), and "strong" (33%). Compared to patients with a strong MiL, patients with a poor or moderate MiL were older, and had lower education level, worse NYHA functional classes, and poorer social support (all p<0.05); had a higher incidence of being divorced, living alone, dependent economic status, and chronic kidney disease (all p<0.05). With respect to physical component of QOL, the physical component scores (PCS) in patients with poor MiL trajectory were significantly lower than those with moderate (p=0.015) and strong (p<0.001) MiL trajectories. With respect to mental component of QOL, the mental component scores (MCS) in patients with poor MiL trajectory were also significantly lower than those with strong MiL. The factors associated with a better QOL included younger (PCS: B=0.21, p<.001), no chronic kidney disease (PCS: B=7.59, p<.001; MCS: B=4.71, p<.001), and stronger MiL (PCS: B=5.30, p<.001; MCS: B=4.71, p=.004). All these factors could explain 53% of the PCS and 32% of MCS.
Conclusion: During the 6 months after discharge from HF hospitalization, one third of patients develop a strong MiL. The elderly and patients with chronic kidney disease are at high risk of developing poor MiL. It is to be investigated whether an early spiritual intervention for these patients can improve their QOL.
Description
Heart failure (HF) patients have three different trajectories of meaning in life after discharge from HF hospitalization. The elderly and patients with low socioeconomic background or chronic kidney disease are at high risk of having poor meaning of life trajectory. A persistent and strong meaning in life trajectory has a significant impact on health-related quality of life.