Quality of life, healthcare access, and perceived impacts of heart failure: patient perspective

Abstract Background Heart failure (HF) is a complex condition requiring people with HF (PwHF) to navigate daily decisions that impact their quality of life and healthcare access. Understanding the perceived effects of HF on individuals’ is crucial for fostering shared decision-making and identifying optimal care strategies. This study aims to assess the correlation between the level of perceived impact of HF on daily living, perceived quality of life, and perceived access to healthcare among PwHF. Methods A cross-sectional study was conducted among PwHF (18+) in Portugal. The survey covered seventeen dimensions of perceived impact, evaluated on a 3-level scale (positive, none, or negative), and perceptions of quality of life and healthcare access (5-level scale from “very bad” to “very good"). The results on the impact were converted into scores between 0 and 10 (0 meaning positive and 10 meaning negative impact). Statistical analysis included Spearman and Pearson correlations. Results A total of 428 responses were analysed. Respondents had a mean age of 70 years and 52.1% were men. 63.3% rated their quality of life as “reasonable” and 47.0% perceived their healthcare access as “good.” The dimensions “Quality of life,” “General health,” and “Mobility” had the highest impact scores (M = 8.65, SD = 2.38; M = 8.65, SD = 2.35; M = 8.43, SD = 2.45, respectively). The mean global impact score was 8.09 (SD = 1.88). A significant negative correlation was found between global impact and perceived quality of life (r = -0.377, p < 0.001), while no significant correlation was found between global impact and perceived healthcare access (r = -0.045, p = 0.354). Conclusions A significant negative correlation between HF impact and perceived quality of life highlights the need for interventions to reduce HF impact. No significant correlation was found between HF impact and perceived healthcare access, suggesting other factors influence healthcare access perception. Key messages • Heart Failure significantly impacts daily life, affecting quality of life and healthcare access. • Patient-centred care strategies that directly address functional limitations and lived experiences are essential to achieving better outcomes and supporting more effective shared decision-making.