Evaluation of the prevalence and severity of pain in Palestinian patients with stable chronic heart failure: impact of pain on quality of life
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Date
2021-08-29
Authors
Deema Mhesin
Hadeel Nazzal
Jalilah Amerah
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Abstract
Introduction: Heart failure (HF) is considered a leading cause of morbidity and mortality among chronic diseases worldwide. Chronic pain in long-standing heart failure has been increasingly complained by patients to be a disturbing symptom. Its unknown etiology and mechanism, besides its insidious progressive nature, made both the doctor and the patient don’t notice it until it affects the quality of life (QOL) and general health status, especially in the late stages of the disease course, because it’s not managed well from the beginning. Although New York Heart Association (NYHA) classification considers pain one of HF symptoms, it is not treated as the main symptom. Therefore, we have studied the prevalence and severity of pain in chronic stable HF patients to understand it better and how much it affects the patient’s QOL because effective treatment depends on this.
Objectives: This study aims to determine the prevalence and severity of pain in chronic heart failure patients and assess its impact on their QOL.
Methods: This is a cross-sectional study of 142 patients in which a targeted questionnaire for chronic heart failure patients is used to determine the severity of pain and its impact on quality of life. It is prepared to be able to obtain relevant answers to contribute to the final results.
Results: The final study had a total of 142 individuals. They had a median EQ-5D score of 0.3 [0.0-0.6] and an EQ-VAS score of 50 [30-70]. There was a statistically significant relationship between pain severity and EQ-5D score (p = 0.001). The relation between pain interference and EQ-5D was also discovered to be statistically significant (p < 0.001). Similarly, the pain severity score (p = 0.026) and the pain interference score (p < 0.001) were both strongly linked with the EQ-VAS score. Furthermore, QOL is substantially connected with gender, social position, employment, educational level, and income level. Concerning EQ-VAS values, regression analysis revealed significant differences (p=0.02) between patients with lower monthly incomes. Additionally, both the pain interference score (p < 0.001) and the pain severity score (p = 0.004) had significant negative relationships with the EQ-VAS score. It also revealed that lower income (p=0.044) level was significantly correlated with EQ-5D score. Additionally, we found that pain severity score (p < 0.001) and pain interference score (p =0.001) had a significant relationship with EQ-5D score.
Conclusions: Chronic pain has a substantial impact on chronic HF patients' quality of life. The subgroups with the lowest QOL are female gender, low education, lower income, and unemployed. Eventually, a significant relationship was found in which the more severe the pain in one patient is, the lower the QOL of that patient. As well, there is a significant correlation between pain interference and QOL.