Methods: A Longitudinal study design. From January to May, 2017, ecruited 80 acute decompensated HF patients from a teaching hospital located in North Taiwan. Data were collected at 3 time points: started from acute phase (during hospitalization due to acute HF, T1), at the first HF clinic visit within one month after discharge (T2), and at 3-month after discharge (T3). Recorded clinical parameters were 6-min walking distance, and questionnaires, including Symptom Distress Scale, Social Support questionnaire, Heart Failure needs Assessment Questionnaire, and Meaning life Questionnaire.
Results: A total of 60 patients completed the 3 times follow-up in this study. Most patients were male (66.3%), with a mean age of 66 years old. The results of this study showed that (1) In response to the disease stress of HF, patients developed a sense of meaning in life at T3. (2) Symptom distress and care needs were severest during T1. Symptom distress and care needs significantly improved at T2 (p < .05). There were no significant changes in social support provided by family from T1 to T3 (p >.05). However, the social support provided by medical staffs was significantly higher at T2, compared to that at T1 ( p < .05), and maintained well up to T3. (3) During the disease trajectory, the factors associated with a stronger sense of meaning in life were as follows. At T1, the associates included having private insurance, participation in social activities, and having more social support. At T2, the associates were age <65 years old, higher education level, and having financial ability. At T3, the associates were higher social support by family, lower care needs, longer walking distance in six minutes (all p < .05). (4) A lower care need (B = -0.10, p = .034) and a higher social support by family at T3 (B = 0.20, p < .001) were significant predictors of a stronger sense of meaning in life.
Conclusion: As the disease progresses, the meaning in life of patients with HF is gradually developed three months after discharge. However, it is the social support of the family and the care needs of the patients that can significantly predict the development of meaning in life. Therefore, it is recommended that during the clinical care process, the patient-family interaction and care needs can be assisted to help the patient develop their existential meaning in life and cope with the stress of HF.