Psychosocial Correlates of Subjects with Heart Failure in Lagos, Nigeria

Abstract

Heart failure (HF) is associated with high morbidity and mortality most especially in developing countries including Nigeria. In the country, most patients present late for treatment and with attendant high treatment default. Thus, the study set out to examine the psychosocial correlates of subjects with HF. It was a cross-sectional study of new patients aged 18 years and above that presented with HF in the cardiology clinic of Lagos University Teaching Hospital (LUTH), Lagos. Each subject had echocardiography done to confirm the diagnosis and grade the severity of HF. Furthermore, the socio-demographic profiles of each subject were obtained and they were also assessed with General Health Questionnaire (GHQ-12) and questionnaire to elicit the attitudes and belief of subjects about HF. In all, 55 subjects were studied over a 6-month period, made up of 25 (45.5%) males and 30 (54.5%) females; with mean age of 51.2+14.0 years. According to New York Heart Association (NYHA) classification, over half (50.9%) of subjects had class II severity of HF followed by classes I and III of 20.0% each. The two commonest causes of HF were dilated cardiomyopathy (47.3%) and Hypertensive Heart Disease,
HHD (30.9%). Forty three (78.2%) of the subjects had >2 scores on GHQ-12, indicating the likelihood of co-morbid psychopathology. Close to half (47.3%) of the subjects believed HF was caused by psychosocial /spiritual causes; with further 12.7% believing in admixed medical and spiritual causes. However, 35 (63.6%) of the subjects believed orthodox care to be the effective treatment for HF while the rest 20 (36.4%) believed in combination of orthodox medical care and spiritual intervention of prayer and “deliverance from the enemies”. Up to 81.8% of subjects believed HF has detrimental effect on work/income, sexual ability and social life. Over half (54.6%) admitted to past use of psychoactive substance but stopped on account of the HF. Only 2 (3.6%) were current users (alcohol). It is concluded that there is need to establish intensive health education on HF and cardiovascular diseases in the country.

Key Words: Heart Failure; Nigeria; Psychosocial; Factors