Quality of Life Among Patients With Heart Failure: A Qualitative Study of Symptom Monitoring, Functional Limitation, and Psychological Uncertainty
Keywords:
Heart failure, Quality of life, Symptom monitoring, Functional limitation, Psychological uncertainty, Self-management, Qualitative study, Patient experienceAbstract
Objective: This study aimed to explore the quality of life experiences of patients with heart failure in Canada, with particular attention to how symptom monitoring, functional limitation, and psychological uncertainty shaped daily functioning, emotional well-being, self-management, and perceived autonomy.
Methods and Materials: This qualitative descriptive study was conducted among 26 adult patients with clinically diagnosed heart failure recruited from outpatient cardiology and heart failure clinics in Canada through purposive sampling. Participants were selected to ensure variation in age, sex, duration of diagnosis, functional status, hospitalization history, and treatment experience. Data were collected using a demographic and clinical information form, semi-structured individual interviews, and researcher field notes. Interviews focused on patients’ experiences of living with heart failure, daily symptom monitoring, physical and social limitations, treatment-related routines, emotional responses, uncertainty about disease progression, and coping strategies. Interviews were audio-recorded, transcribed verbatim, anonymized, and analyzed using conventional qualitative content analysis. Meaning units were extracted, coded inductively, grouped into subcategories and categories, and then abstracted into main themes. Credibility was enhanced through team-based review, member checking, reflexive notes, and an audit trail.
Findings: The analysis identified three main themes explaining quality of life among patients with heart failure. The first theme, living under continuous symptom monitoring, showed that participants constantly observed breathing, swelling, fatigue, weight change, dizziness, and treatment effects, which created both perceived control and emotional vigilance. The second theme, restriction of daily function and social participation, indicated that reduced walking capacity, difficulty climbing stairs, activity pacing, dependence on family members, occupational changes, and social withdrawal weakened autonomy and identity. The third theme, psychological uncertainty and emotional burden, revealed persistent fear of sudden deterioration, hospitalization, disease progression, and mortality. Adaptive coping strategies, including acceptance, family support, spiritual coping, communication with healthcare providers, and prioritizing meaningful activities, moderated but did not eliminate these burdens.
Conclusion: Quality of life among patients with heart failure was shaped by the interaction of symptom vigilance, functional restriction, and psychological uncertainty, indicating the need for patient-centered care that integrates self-management education, emotional support, family involvement, rehabilitation, and early supportive care.
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Copyright (c) 2026 Arben Krasniqi (Author); Ryan MacDonald
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