The Impact of Symptom Distress on Demoralization in Patients with Advanced Heart Failure

Abstract

Background: Life quality of patients with advanced heart failure was strongly impacted by symptom distress. Illness trajectory of end-stage heart faliure varies significantly, and the unpredictable compensation imbalance may be life threatening and lead to death. At the end stage, physical activities and functions were strongly influenced by symptom distress, the resulting helplessness, hopelessness, and loss of meaning in turn affect the mental state and prognosis. Specific Aim: To investigate the factors correlated to symptom distress and demoralization in patients with advanced heart failure. Methods: In the cross-sectional correlation study, data was collected by conventional sampling with structured questionnaires. SPSS 23.0 for Windows/PC was used for descriptive and inferential statistical analysis. Results: In the total 71 participants, 43.7% were categorized as high demoralization (DSMV score>30). Regression analysis revealed significant correlation between symptom distress and demoralization (R2=48%, β=.402, p<.001) under the predictive effect of controlled variables. The higher score the symptom distress, the more severe the demoralization. Discussion: Advanced heart failure is a complex disease characterized by multiple comorbidities, significant symptom distress, limitations in physical functions, and impacts on mental health. Early clinical identification and evaluation should be promoted to establish demoralization-related care to improve patients’ quality of life.