Quality of life (QOL) of clients following a percutaneous coronary intervention (PCI).

Abstract

This descriptive study investigated the quality of life of individuals following percutaneous coronary intervention (PCJ) in the local general hospital. Literature suggests that quality of life (QOL) is a complex concept composed of the bio-psycho-social and environmental domains. However, research on QOL was mainly oriented towards the physical health perspective. Research on clients' QOL post PCI is minimal and no studies were traced on QOL post PCI in Malta. Thus, there was the need to investigate the holistic view of QOL of clients who underwent PCI between January 2009 and March 2010 in order to fill in this research gap. The aims of the study were to investigate the overall QOL of clients post PCJ and to identify possible significant differences in the overall QOL and in the four domains of QOL between subgroups of clients' characteristics and their perceived cardiovascular risk factors. Originally, a longitudinal study was planned but due to problems of availability of stents at the local general hospital, a cross-sectional descriptive retrospective quantitative research design was adopted. Data were collected by the mailed Maltese version of the WHOQOL-BREF questionnaire with a response rate of 67%. For better comprehension of the tool, a panel of linguistic experts translated the tool into the Maltese language which was test-retested on clients undergoing an angiogram (n=230) with a response rate of 36.1% (n=83) in both Test 1 and Test 2. The reliability Cronbach alpha coefficient was 0.778 which demonstrated its internal consistency. The participants for the main data collection were recruited by a systematic sampling technique, whereby every second client was selected from the list available at the local general hospital. Questionnaires were mailed to 357 clients out of a population of 714 clients who had undergone PCI with a response rate of 67%. According to the WHOQOL protocol, 12 lV questionnaires were discarded as they had more than 20% missing data. Thus, the valid sample (n=228, males n=169, females n=59), aged between (40-89) years rendered a response rate of 64%. The data underwent inferential statistical analysis by the PASW statistics version 18. The Hierarchy of Human Needs Theory (Maslow 1999) guided the study and provided rationale for the quantitative findings. The findings showed consistently high mean scores of the social domain of QOL and the stress factor with various significant differences in QOL between various subgroups of the sample's characteristics. The social domain appeared to yield high mean scores of the overall QOL irrespective of the presence of cardiovascular risk factors, such as high smoking and lack of physical exercise. Thus social relationships may enhance QOL as it may yield security in life, feelings of love and belonging to the community group. Stress was found high which appeared to generate significant differences in the physical, psychological, social and environmental domains of QOL, including the overall QOL. While considering the limitations of this study, such as collecting only the quantitative data and being a retrospective cross-sectional study, recommendations were set to the management, clinical and education sectors in order to enhance the QOL of clients post PCI. Since stress was prominent in this study, clients need to be followed up in the community and supported by counseling services and stress management programmes. Further research is suggested to explore further these variables and other possible influencing factors by means of a longitudinal study collecting both quantitative and qualitative data in order to enhance the QOL of clients post PCJ.