Relationship of physical symptoms and physical functioning to depression in patients with heart failure.

Objective: The purpose of this study was to determine the relative contribution of physical symptoms and physical functioning to depression in adult patients with heart failure during hospitalization and the early postdischarge period.

Design: An exploratory, correlational longitudinal design was used.

Patients: The sample included 170 subjects with heart failure.

Results: Subjects' mean scores on the depression scale indicated that subjects were not depressed on average; however, 30% of the sample (n = 52) had scores indicative of clinical depression. Both physical symptoms (r = 0.48) and physical functioning (r = -0.32) were moderately correlated with depression. Physical symptoms contributed 13% uniquely to the variance in depression while physical functioning contributed only 2% uniquely to the variance in depression. Multiple regression analyses indicated that physical symptomatology is more closely related to depression than is physical functioning in adults with heart failure.

Conclusions: This study showed the patients with heart failure who had increased physical symptoms and poorer physical functioning reported increased symptoms of depression. Physical symptoms explained a greater portion of the variance in depression than did physical functioning. Thus, it appears that patients with heart failure are affected emotionally by both their physical symptoms and their limitations in their physical functioning, but depression is more strongly related to having more physical symptoms than having greater limitations in physical functioning.