Psychological distress in heart failure patients is associated with health status, but not functional status

Introduction: Heart failure (HF) is a prevalent condition characterized by the heart's inability to supply a suitable volume of blood required for the metabolic needs of the body. The risk to HF is approximated at one in five for a 40-year-old individual in Europe and North America, with an increasing prevalence of 2–3% estimated in both Europe and the United States. There is a clear correlation between HF and psychological distress, with the latter being strongly associated with enhanced risks of rehospitalization and mortality, the severity of physical symptoms, and the patients' quality of life. Although psychological factors, including health status perception, are considered better predictors of psychological distress in people with HF than functional status variables, literature on the topic is lacking. This cross-sectional study aimed to explore the potential associations between psychological distress, health status, and functional status in HF. Methods: A total of 123 non-hospitalized outpatients diagnosed with HF were included in the study. The New York Heart Association classification was used to assess functional status, while health status was measured using the Kansas City Cardiomyopathy Questionnaire (KCCQ). Psychological distress was evaluated using the Hospital Anxiety and Depression Scale. One-way ANOVA and the General Linear Model were the statistical operations used. Results: Significant associations were found between psychological distress and health status, as measured by the KCCQ Total Symptom Score, Overall Summary Score, Quality of Life and Symptom Burden subscales. However, functional status did not show a significant association with psychological distress. Discussion: The results highlight that health status, rather than functional status, may be a more important predictor of psychological distress in patients with HF. In addition, reading the results suggests the importance of considering health status and psychological distress in the management of HF to improve the overall well-being and quality of life of patients, indicating the need for further research and interventions targeting patient-reported health status.