Health Related Quality of Life in Coronary Patients.

Resumen

The increase observed in the survival of patients with ischemic cardiopathy, together withthe effect of the disease on the social, professional, and family life of those suffering from it,have led researchers to consider that the traditional ways of measuring morbidity andmortality are not adequate for assessing the potential benefits of health care interventions.For this reason, there is common agreement on the need to use an indicator of subjectiveassessment of health, and of health related quality of life (HRQL), as a complementarycriterion for monitoring the results of medical interventions in these patients.The term "quality of life" (QoL) or health related quality of life (HRQL) came into use duringthe 1970s as a multidimensional concept reflecting the overall subjective condition of thephysical and mental welfare of the individual, which is a consequence not only of thedisease but also of the family and social conditions forming the patient’s environment.The assessment of these patients’ HRQL has been tackled by several authors using bothdisease-specific and generic instruments such as the Nottingham Health Profile, the SicknessImpact Profile, the SF-36 or the SF-12 health questionnaire. Both types of instrument haveadvantages and disadvantages, and they may provide additional information since theyquantify the patient’s overall health.Using different multidimensional measures, poorer HRQL has been observed in patientswith Acute Myocardial Infarction (AMI) and angina pectoris than in other populations, andthese differences have been related to low social class, female sex, the presence of mentaldisorders and the severity of the clinical condition.Measuring changes in the HRQL of coronary patients is also important as a way of assessinginterventions and predicting needs for social care, because it has been shown that the focusof attention in the immediate period following a cardiac attack is generally the physicalfunctioning, but following discharge from hospital and in the longer term, general health,vitality, social and emotional functions could be at least as important.In this chapter, we aim to provide an overview of the concept of HRQL and the usefulnessof this measure from the perspective of a coronary patient. Likewise, we intend to reviewthe main instruments used to assess HRQL and we analyse the factors that have been seento affect the quality of life of these patients.