Top

Quality of Life Research

Gepubliceerd in:

01-12-2007

Cluster analysis: a useful technique to identify elderly cardiac patients at risk for poor quality of life

Auteurs: Yoshimi Fukuoka, Teri G. Lindgren, Sally H. Rankin, Bruce A. Cooper, Diane L. Carroll

Gepubliceerd in: Quality of Life Research | Uitgave 10/2007

Abstract

Objective

The purposes of this study are (1) to examine the frequency of cardiac symptoms in elderly people one year after acute myocardial infarction (AMI) and/or coronary artery bypass surgery (CABG); (2) to identify patient subgroups (cluster solutions) based on cardiac symptoms after cardiac events and (3) to determine if these subgroups vary based on health related quality of life and psychological distress.

Methods

A sample of 206 elderly, unpartnered, patients (age ≥ 65) were interviewed one year after AMI and/or CABG by telephone. Cardiac symptoms, SF-36, POMS, and QOL-I were measured. A hierarchical cluster analysis was used to identify patient subgroups based on cardiac symptoms, using a combination of dendrograms and stopping rules.

Results

Three subgroups were identified: (1) the Weary (19.4%), (2) the Diffuse symptom (68.4%), and (3) the Breathless groups (12.2%). The Weary group had significantly lower scores on all of SF-36 subscales (except for social functioning) and higher scores on all of POMS subscales (except for Anger/hostility and Confusion/Bewilderment) compared to the Diffuse symptom group.

Conclusions

The cluster analysis was useful to identify the subgroup with poorer recovery. Patients in the Weary group need more attention and intervention strategies to improve their health.

vorige artikel Respondent satisfaction regarding SF-36 and EQ-5D, and patients’ perspectives concerning health outcome assessment within routine health care

volgende artikel Marker states and a health state prompt provide modest improvements in the reliability and validity of the standard gamble and rating scale in prostate cancer patients

Note that some researchers might use the pragmatic approach of dichotomizing continuous scores into extreme groups, or at the median, in order to find groups of observations with similar classifications of the dichotomies—as this would be done in a multi-way contingency table. This practice of dichotomizing variables “wastes” variance and could lead to serious errors in estimation [19, 20] .

He, W., Sengupta, M., Velkoff, A. V., et al. (2005). U.S. Census Bureau: Current population report, 65+ in the United States: 2005 (Vol. 30). Washington, DC: U.S.: Government Printing Office.

American Heart Association (2007). 2007 Statistical Fact Sheet – Populations: Older Americans and cardiovascular diseases – Statistics. American Heart Association.

Westin, L., Nilstun, T., Carlsson, R., et al. (2005). Patients with ischemic heart disease: Quality of life predicts long-term mortality. Scandinavian Cardiovascular Journal, 39(1–2), 50–54.PubMedCrossRef

Rumsfeld, J. S., MaWhinney, S., McCarthy, M., Jr., et al. (1999). Health-related quality of life as a predictor of mortality following coronary artery bypass graft surgery. Participants of the Department of Veterans Affairs Cooperative Study Group on Processes, Structures, and Outcomes of Care in Cardiac Surgery. JAMA, 281(14), 1298–1303.PubMedCrossRef

Grace, S. L., Abbey, S. E., Irvine, J., et al. (2004). Prospective examination of anxiety persistence and its relationship to cardiac symptoms and recurrent cardiac events. Psychotherapy and Psychosomatics, 73(6), 344–352.PubMedCrossRef

Dodd, M. J., Miaskowski, C., & Paul, S. M. (2001). Symptom clusters and their effect on the functional status of patients with cancer. Oncology Nursing Forum, 28(3), 465–470.PubMed

Gift, A. G., Jablonski, A., Stommel, M., et al. (2004). Symptom clusters in elderly patients with lung cancer. Oncology Nursing Forum, 31(2), 202–212.PubMedCrossRef

Kim, H. J., McGuire, D. B., Tulman, L., et al. (2005). Symptom clusters: Concept analysis and clinical implications for cancer nursing. Cancer Nursing, 28(4), 270–282 (quiz 283–274).PubMedCrossRef

Gorsuch, R. L. (1983). Factor analysis. Mahwah, NJ: Lawrence Erlbaum Associates.

10.

Thompson, B. (2004). Exploratory and confirmatory factor analysis: Understanding concepts and applications. Washington, D.C.: American Psychological Association.

11.

Carroll, D. L., Rankin, S. H., & Cooper, B. A. (2007). The effects of a collaborative peer advisor/advanced practice nurse intervention: Cardiac rehabilitation participation and rehospitalization in older adults after a cardiac event. Journal of Cardiovascular Nursing, 22(4), 313–319.PubMed

12.

Stewart, A. L., Hays, R. D., & Ware, J. E., Jr. (1988). The MOS short-form general health survey. Reliability and validity in a patient population. Medical Care, 26(7), 724–735.PubMedCrossRef

13.

Ferrans, C. E., & Ferrell, B. R. (1992). [Quality of life studies in nursing science (1). Development of a quality of life index for patients]. Kango Kenkyu, 25(2), 117–124.PubMed

14.

McNair, D. M., Lorr, M., & Droppleman, L. F. (1992). POMS manual: Profile of mood states. San Diego, CA: Edits.

15.

Sherbourne, C. D., & Stewart, A. L. (1991). The MOS social support survey. Social Science and Medicine, 32(6), 705–714.PubMedCrossRef

16.

Lindgren, G. T., Fukuoka, Y., Rankin, H. S., et al. (In press). Cluster analysis of elderly cardiac patients’ prehospital symptomatology. Nursing Research.

17.

Charlson, M. E., Pompei, P., Ales, K. L., et al. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. Journal of Chronic Diseases, 40(5), 373–383.PubMedCrossRef

18.

Everitt, B. S., Landau, S., & Leese, M. (2001). Cluster analysis. New York: Oxford Univ. Press.

19.

MacCallum, R. C., Zhang, S., Preacher, K. J., et al. (2002). On the practice of dichotomization of quantitative variables. Psychological Methods, 7(1), 19–40.PubMedCrossRef

20.

Royston, P., Altman, D. G., & Sauerbrei, W. (2006). Dichotomizing continuous predictors in multiple regression: A bad idea. Statistics in Medicine, 25(1), 127–141.PubMedCrossRef

21.

Milligan, G., & Cooper, M. (1985). An examination of procedures for determining the number of clusters in a data set. Psychometrika, 50(2), 159–179.CrossRef

22.

Miaskowski, C., Cooper, B. A., Paul, S. M., et al. (2006). Subgroups of patients with cancer with different symptom experiences and quality-of-life outcomes: a cluster analysis. Oncology Nursing Forum, 33(5), E79–89.PubMedCrossRef

23.

Fox, S. W., & Lyon, D. E. (2006). Symptom clusters and quality of life in survivors of lung cancer. Oncology Nursing Forum, 33(5), 931–936.PubMedCrossRef

24.

Agewall, S., Berglund, M., & Henareh, L. (2004). Reduced quality of life after myocardial infarction in women compared with men. Clinical Cardiology, 27(5), 271–274.PubMedCrossRef

25.

Lukkarinen, H., & Hentinen, M. (1998). Assessment of quality of life with the Nottingham Health Profile among women with coronary artery disease. Heart & Lung, 27(3), 189–199.CrossRef

26.

Herlitz, J., Wiklund, I., Sjoland, H., et al. (2001). Relief of symptoms and improvement of health-related quality of life five years after coronary artery bypass graft in women and men. Clinical Cardiology, 24(5), 385–392.PubMedCrossRef

27.

Aben, I., Verhey, F., Strik, J., et al. (2003). A comparative study into the one year cumulative incidence of depression after stroke and myocardial infarction. Journal of Neurology and Neurosurgery Psychiatry, 74(5), 581–585.CrossRef

28.

Thombs, B. D., Bass, E. B., Ford, D. E., et al. (2006). Prevalence of depression in survivors of acute myocardial infarction. Journal of General Internal Medicine, 21(1), 30–38.PubMedCrossRef

29.

Lenzen, M., Scholte op Reimer, W., Norekval, T. M., et al. (2006). Pharmacological treatment and perceived health status during 1-year follow up in patients diagnosed with coronary artery disease, but ineligible for revascularization. Results from the Euro Heart Survey on Coronary Revascularization. European Journal of Cardiovascular Nursing, 5(2), 115–121.PubMedCrossRef

30.

Lesman-Leegte, I., Jaarsma, T., Sanderman, R., et al. (2006). Depressive symptoms are prominent among elderly hospitalised heart failure patients. European Journal of Heart Failure, 8(6), 634–640.PubMedCrossRef

31.

Freedland, K. E., Rich, M. W., Skala, J. A., et al. (2003). Prevalence of depression in hospitalized patients with congestive heart failure. Psychosomatic Medicine, 65(1), 119–128.PubMedCrossRef

Titel: Cluster analysis: a useful technique to identify elderly cardiac patients at risk for poor quality of life
Auteurs: Yoshimi Fukuoka
Teri G. Lindgren
Sally H. Rankin
Bruce A. Cooper
Diane L. Carroll
Publicatiedatum: 01-12-2007
Uitgeverij: Springer Netherlands
Gepubliceerd in: Quality of Life Research / Uitgave 10/2007
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-007-9272-7

Bohn Stafleu van Loghum

Deel dit onderdeel of sectie (kopieer de link)

Abstract

Objective

Methods

Results

Conclusions

Log in om toegang te krijgen

Andere artikelen Uitgave 10/2007

Marker states and a health state prompt provide modest improvements in the reliability and validity of the standard gamble and rating scale in prostate cancer patients

Quality of life of adults with workplace exacerbation of asthma

Respondent satisfaction regarding SF-36 and EQ-5D, and patients’ perspectives concerning health outcome assessment within routine health care

The water exercise improves health-related quality of life of frail elderly people at day service facility

Response shift due to diagnosis and primary treatment of localized prostate cancer: a then-test and a vignette study

Long-term health-related quality of life in survivors of meningococcal septic shock in childhood and their parents