الفهرس 
CARDIAC ARRHYTHMIASOnly 14 pages are availabe for public view
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Abstract
Cardiac arrhythmia is associated with substantial morbidity, mortality, and increase healthcare costs. This disease is a broad diagnosis category that can be separated into atrial arrhythmias, ventricular arrhythmias, conduction system disease, and supraventricular arrhythmias. The treatment of arrhythmias is complex and dependent on the type of arrhythmia. Basic arrhythmias are usually first identified in patients presenting with symptoms such as palpitations or syncope, and confirmed with a 12 lead ECG. Furthermore, it has been shown that when there is an increase in arrhythmias symptom burden that leads to a decrease in quality of life (QOL) for these patients (Abd-Elsayed, 2020).
Aim of the Study:
The present study was conducted to fulfill the following aim:
Assess of arrhythmias symptom burden on patients’ quality of life through the following:
1- Assessing symptom burden of patients with arrhythmias.
2- Assessing health related quality of life patients with arrhythmias.
Research Questions:
This study was conducted for answering the following questions:
1- What are symptom burden for patients with arrhythmias?
2- What are the effect of symptom burden on patients’ quality of life?
Research design:
A descriptive exploratory study was utilized to meet the aim of this study
Setting:
The study was conducted in outpatient cardiac clinics which affiliated at Magdy Yacoub foundation, Aswan heart centre.
Subject:
The study subjects composed of Purposive sample of 100 adult patients, based on this inclusion criteria Adult patient over 18 years’ old who suffering from arrhythmia, from both genders, able to comprehend instructions, agree to participate in this study and free from mentally, psychiatric disorders.
Tools of data collection:
Data for this study were collected using the following two tools:
Data was collected using the following three tools:
Tool 1- Patients’ interview questionnaire:
It was designed by the investigator and was written in Arabic language based on recent literature (American college of cardiology foundation, 2017), it was filled by the investigator.
Included the following parts:
The first part: It was included 7 items concerned with socio demographic data of patients under the study including “age, gender, marital status, level of education, work, residence and monthly income”.
The second part: It was included 5 questions concerned with the patients’ personal habits related to disease included “smoking habits, number of cigarettes, alcohol intake, drug addiction, and exercise programme.
The third part: It was concerned with the collection of data about current medical history, past medical history, past surgical history and family history.
Current medical history: It was included” 15” questions about ”body mass index, the length of hospital stay, chief complain when patient come to hospital, duration of arrhythmia, How long the arrhythmia last about, the longest time of experienced arrhythmia in the last 3 months, How many times have patient experienced arrhythmia in the last three months, What is the arrhythmia associated with, Does arrhythmia occur at specific times, arrhythmia occur at specific time, Have patient ever felt faint in connection with arrhythmia, Have patient ever fainted in connection with arrhythmia, Does patient have any allergy and its types if found in addition to patient current medication such as “anticoagulant drugs, cholesterol drugs, hypertension drugs and diabetics drugs”.
Past medical history: Included” 1 “question about chronic disease which include “diabetes, hypertension, heart disease or vascular disease”.
Past surgical history: Included” 2 “questions about past surgical history and type of surgery.
Family history: Included” 2 “questions, about if any one family member suffers from cardiac disease and if patient had sudden death condition at his family.
Tool (2): Arrhythmia symptom burden scale:
This tool will be used to assess symptom burden for patients with arrhythmia after reviewing related literatures. This part evaluates commonly experienced symptoms in a symptom burden scale with nine different symptoms where a sum score is calculated for the items, where a lower score represents less symptom severity, this tool was adopted from (Walfridsson et al., 2012).
Tool (3): 36-Items Short-Form health survey:
This tool used to assess physical, social and psychological domains for patients with arrhythmia and this tool was adopted from (Ware & Sherbourne, 1992). And comprises 36 items grouped into eight scales. The eight scales represent physical functioning include 3- 12 question, role limitations due to physical health problems include 13- 15 question, bodily pain include 21,22, general health include 1,33-36, vitality energy/fatigue include23,27, 29,31, social functioning include 20,32, role limitations due to emotional problems include 17, 18, 19 and mental health (psychological distress and psychological well-being) include 24, 25, 26, 28, 30.
Results:
The important findings that were obtained from the study can be summarized as follows:
• Socio demographic data of the studied subjects; revealed that their mean age was 43.55±8.44, 52 % of them were female, furthermore 78 % of them were married status. And 40% of them had high education.
• More than half of the studied subjects 54% of them not working even though 71% of them had enough monthly income. And 85% of studied subjects were lived at urban.
• The majority of the studied subjects 92 % were not smoking, not alcohol drank or drugs addicts, also the majority of them did not have regular exercise programme.
• More than one third of the studied subjects had normal body weight, and more than two third of them and the disease from 1 to 5 years and arrhythmia was lasting less than 1 hour.
• More than two third of the studied subjects 71% had complain of palpitation, and 16 % had breathlessness complaints, while 10 % had chest pain, and only 3% had peripheral cyanosis and edema.
• Arrhythmia occurrence on more than two third of the studied subject’s associated with irregular heartbeats. And 98 % of them state of that the occurrence of arrhythmia was done in specific time, while 62 % of them increase with effort and 86 % of studied subject felt in faint with arrhythmia but only 38 % of them were actually faint with arrhythmias.
• The majority of the studied subjects 95% did not have a history of allergy. Also, majority 92 % of them were taken anti- coagulant dug. While 62 % of them were taken drug for cholesterol. Also, 64 % of them were taken hypertension drugs. But only 15 % of them had diabetics drug.
• More than two third of the studied subjects 64% of them had past medical history of hypertension. And 94% of them had past medical history of vascular disease while 85% of studied subjects did not have any surgical history. On the other hand, only 30% them had family history of cardiac disease and 15 % of them had family history of sudden death.
• According to symptom burden: More than two third of the studied subjects70% were breathlessness a lot during activity. While, half of them 51% had breathlessness a lot even at rest. On the other hand, 65 % of studied subjects were tiredness a lot. Also, 60% of them were feeling weakness/fatigue a lot.
• The highest affected dimension of quality of life with cardiac arrhythmia was physical function. while the least affected dimension was emotional dimension.
• There was no significant correlation between symptom burden and socio demographic data of the studied subjects.
• There was negative correlation between symptom burden and physical function of studied subjects, pain, general health, social activity. While there was positive correlation between symptoms burden and energy, role limitation due to emotional problem, general mental health due to psychological distress and psychological well-being and role limitation due to physical health problems.
• There was negative significant relation between symptom burden and quality of life
Conclusion:
Based on findings of the present study, it can be concluded that:
Overall, the current study was concluded that, about two third of the studied subjects had a lot of symptom burden experienced with arrhythmias such as (breathlessness during activity, tiredness, feeling weakness). Also, it was concluded that the highest affected dimension of the quality of life with cardiac arrhythmia was physical function, while the least affected dimension was emotional dimension. On the other hand, arrhythmia symptom burden was negatively affected patients’ quality of life.
Recommendations:
The following recommendations were inferred from the study:
• Further research studies are needed to focus on studying the effect of arrhythmia symptom burden on cardiac patients’ quality of life to generalize result of the current study.
• Designing an educational program for arrhythmic patient to increase patient knowledge and to improve their health-related quality of life.
• Rehabilitations programs regarding life style modification including for helping patients suffering from arrhythmias cope with their health problems thereby improving quality of life.