Perceived Social Isolation in Heart Failure

Abstract

Patients with heart failure (HF) experience social isolation associated with an increased risk of morbidity, mortality, and elevated health care expenditures. The aim of this study was to evaluate the factors associated with perceived social isolation and to assess the impact of fatigue on social isolation. A total of 100 HF outpatients were enrolled by convenience sampling. Data were collected by completion of the Greek version of the Modified Fatigue Impact Scale (MFIS-Greek), which also included patients' characteristics and their self-report about social isolation. Of the 100 participants (68% men; mean age, 68.6 ± 7.1 years), 78% reported perceiving social isolation. Factors significantly associated with perceived social isolation were female sex (P = .001), New York Heart Association class IV (P = .001), stress about HF (P = .002), paroxysmal nocturnal dyspnea (P = .030), edema in the lower limbs (P = .001), report of receiving many medications (P = .001), change in body image (P = .032), and not following limitations in fluid and sodium intake (P = .001). The MFIS total score determined moderate to high levels of fatigue (median, 70 points; range, 21-105 points). Total fatigue was statistically significantly associated with social isolation as perceived by patients (P = .001). In conclusion, demographic and clinical characteristics as well as fatigue are associated with perceived social isolation. It is essential to evaluate social isolation in routine practice.

Keywords: Heart failure; fatigue; perceived social isolation.