Methods: A cross-sectional, descriptive correlational design was employed. A purposive sample of 125 participants was recruited from the outpatient departments of two hospitals located in southern Taiwan. Participants were individually interviewed to complete the Kansas City Cardiomyopathy Questionnaire (KCCQ), Charlson Comorbidity Index, Pittsburgh Sleep Quality Index, and Epworth Sleepiness Scale.

Results: The mean KCCQ overall summary score for the 125 participants was 70.50±19.63 (normal range 0-100, high scores indicating better HRQOL). The physical symptom domain had the highest score, and psychological status was the lowest. Six predictors were identified using a three-step hierarchical multiple regression analysis, accounted for 58.5% (p<.001) of variance in HRQOL. Overall, the study found that Taiwanese people with heart failure who experienced better HRQOL were those who had higher levels of education, lower New York Heart Association Classes, and smaller numbers of comorbid conditions, and reported better subjective sleep quality, fewer sleep disturbances, and shorter sleep latency.

Conclusion: Since psychological status had the lowest score among HRQOL domains, routinely assessing heart failure patients' emotional status is recommended. Assessing patients' perceptions of their heart failure severity and impact on HRQOL is important as a part of heart failure care and teaching. Early detection of sleep disorders may help healthcare providers minimize potential poor outcomes and improve HRQOL in people with heart failure. Overall, the study findings support the view that HRQOL is an extremely complex concept. Nurses should use a holistic perspective to help patients understand and manage the impact of heart failure on their daily lives.