Meaning-making and quality of life in heart failure interventions: a systematic review.

ABSTRACT

PURPOSE: Heart failure (HF) patients often report high levels of psychological distress and diminished quality of life (QoL). As such, interventions aimed at improving their QoL and other positive psychosocial outcomes are needed. Some interventions have shown promise, but results are mixed. Interventions directed toward physical well-being (e.g., self-care behaviors, medical adherence) may be less effective at improving QoL than those aimed at improving psychological well-being (e.g., stress reduction, coping strategies). We systematically reviewed recent HF interventions and compared results of those emphasizing coping strategies related to meaning-making to those lacking meaning-making components as a possible factor in QoL discrepancies. METHODS: A systematic review of four databases produced 439 studies for potential inclusion, of which 25 qualified for review. These were coded into substantial or minimal meaning focus. RESULTS: Forty percent of all studies (n = 10) reported improved QoL due to intervention effects, while 60% reported no significant change in QoL (60%; n = 15). Fewer than one-third of minimal meaning focus studies demonstrated significant improvements in QoL (30.8%; n = 4). In contrast, half of substantial meaning focus studies demonstrated significant improvements in QoL (50%; n = 6). CONCLUSIONS: By clarifying the potential importance of promoting meaning-making in improving QoL of HF patients, we highlight its potential value in future interventions directed to this underserved, high-risk patient population.