Sense of coherence and quality of life in patients treated with antivitamin k oral anticoagulants: a cross-sectional study

In e na ional Jou nal o En i onmen al Resea ch and Public Heal h A icle Sense o Cohe ence and Quali y o Li e in Pa ien s T ea ed wi h An i i amin K O al An icoagulan s: A C oss-Sec ional S udy Ana Anguas-G acia 1,2,3 , Ana Belén Subi ón-Vale a 1,3,4 , Bea iz Rod íguez-Roca 1,Ángel Gasch-Gallén1,5,* , Isabel An ón-Solanas 1,5,* and Fe nando U cola-Pa do 1,3   Ci a ion: Anguas-G acia, A.; Subi ón-Vale a, A.B.; Rod íguez-Roca, B.; Gasch-Gallén, Á.; An ón-Solanas, I.; U cola-Pa do, F. Sense o Cohe ence and Quali y o Li e in Pa ien s T ea ed wi h An i i amin K O al An icoagulan s: A C oss-Sec ional S udy. In . J. En i on. Res. Public Heal h 2021,18, 1668. h ps://doi.o g/10.3390/ ije ph18041668 Academic Edi o s: Lau a Galiana, JoséManuel, Tomás Miguel, Ampa o Oli e and Pa ícia Sancho Recei ed: 21 Decembe 2020 Accep ed: 5 Feb ua y 2021 Published: 9 Feb ua y 2021 Publishe ’s No e: MDPI s ays neu al wi h ega d o ju isdic ional claims in published maps and ins i u ional a il- ia ions. Copy igh : © 2021 by he au ho s. Licensee MDPI, Basel, Swi ze land. This a icle is an open access a icle dis ibu ed unde he e ms and condi ions o he C ea i e Commons A ibu ion (CC BY) license (h ps:// c ea i ecommons.o g/licenses/by/ 4.0/). 1Depa men o Physia y and Nu sing, Facul y o Heal h Sciences, Uni e si y o Za agoza, C/Domingo Mi al s/n, 50009 Za agoza, Spain; aanguas@uniza .es (A.A.-G.); subi on@uniza .es (A.B.S.-V.); b od iguez@uniza .es (B.R.-R.); u cola@uniza .es (F.U.-P.) 2Resea ch G oup Sa e y and Ca e (GIISA0021), Ins i u e o Resea ch o A agón, 50009 Za agoza, Spain 3Resea ch G oup Wa e and En i onmen al Heal h (B43_20R), Uni e si y Ins i u e o Resea ch in En i onmen al Science o A agón, Uni e si y o Za agoza, 50009 Za agoza, Spain 4Resea ch G oup Sec o III Heal hca e (GIIS081), Ins i u e o Resea ch o A agón, 50009 Za agoza, Spain 5Resea ch G oup Nu sing Resea ch in P ima y Ca e in A agón (GENIAPA) (GIIS094), Ins i u e o Resea ch o A agón, 50009 Za agoza, Spain *Co espondence: angelgasch@uniza .es (Á.G.-G.); ian on@uniza .es (I.A.-S.) Abs ac : The aim o his s udy was o analyze he co ela ion be ween he pa icipan s’ sel - epo ed quali y o li e and hei sense o cohe ence in a sample (n= 85) o pa ien s on ea men wi h o al an i i amin K an icoagulan s. A c oss-sec ional design was used. The measu emen ins umen s included a ques ionnai e on sociodemog aphic a iables, he Spanish e sion o he Abb e ia ed Wo ld Heal h O ganiza ion Quali y o Li e ques ionnai e (WHOQOL-BREF), an o al-an icoagulan - ea men -speci ic quali y-o -li e ques ionnai e, and he sense-o -cohe ence (SOC) scale. We analyzed he co ela ions be ween he pa icipan s’ cha ac e is ics and he esul s om he quali y-o -li e and SOC scales. Age, le el o educa ion, employmen s a us, li ing a angemen , and ea men leng h we e he de e minan s o he quali y o li e in people ea ed wi h o al an icoagulan s. We ound a signi ican associa ion be ween he ou domains o he WHOQOL-BREF ques ionnai e and gene al ea men sa is ac ion (p< 0.01); no signi ican co ela ions we e ound be ween he SOC subscales and he o al-an icoagulan - ea men -speci ic quali y o li e in ou sample. Women had a wo se le el o sel -managemen han men. Nu sing in e en ions should be ailo ed o he needs o he popula ions on ea men wi h o al an icoagulan s in o de o acili a e a highe le el o sel -managemen . Keywo ds: quali y o li e; an icoagulan s; p ima y heal hca e; sel -e icacy; sense o cohe ence 1. In oduc ion An i i amin K o al an icoagulan s (AKOA) unc ion by educing plasma concen a- ions o he i amin-K-dependen p o eins (FII, FVII, FIX, FX, p o ein C, and p o ein S) and a e c ucial in he pha macological ea men o ca diac and h omboembolic diso de s, as well as a ial ib illa ion [ 1 ]. In Spain, he mos equen ly p esc ibed AKOA a e wa a in and acenocouma ol. The p e alence o he use o AKOA in Spain is 1.3%, wi h no signi i- can di e ences be ween men and women [ 2 ]. Pa ien s on ea men wi h hese AKOA a e gene ally olde adul s, wi h an a e age age o 76 (SD 11.4) [3]. Almos h ee-qua e s o his popula ion (72%) a e managed in he communi y by p ima y heal hca e p o essionals. This equi es equen ollow-up isi s in o de o gua - an ee clinical sa e y h ough dose adjus men and close moni o ing o pa ien s’ sensi i i y o ea men [ 4 ]. Fo ins ance, concomi an ea men wi h AKOA and an ipla ele s such as nin edanib may esul in side e ec s, including gas oin es inal bleeding and pe o a- ion [ 5 ]. In hese cases, indi idual assessmen s o bleeding isks in ol ing he apeu ic In . J. En i on. Res. Public Heal h 2021,18, 1668. h ps://doi.o g/10.3390/ije ph18041668 h ps://www.mdpi.com/jou nal/ije ph In . J. En i on. Res. Public Heal h 2021,18, 1668 2 o 15 d ug moni o ing should be ca ied ou egula ly. Howe e , he e ec i eness o ea men wi h AKOA is also in luenced by o he ac o s such as ea men adhe ence and disease- coping s a egies. Heal h educa ion is an impo an ool in he managemen o pa ien s on ea men wi h AKOA and should include in o ma ion ela ed o die a y, abso p i e, compliance, and pha macological ac o s [ 6 ]. Fu he mo e, a co ela ion has been ound be ween op imal AKOA ea men con ol and pa ien s’ illness pe cep ion; ha is, pa ien s who accep hei illness and unde s and he ea men is mo e likely o achie e be e in e na ional no malized a io (INR) con ol [ 7 ]. Howe e , disease ch onici y, impac o he disease on daily li e, and he p esence o o he como bidi ies can lead o a educed quali y o li e (QoL) in people ea ed wi h AKOA, as well as hei closes ela i es and ca egi e s [8]. Acco ding o he Wo ld Heal h O ganiza ion (WHO), he QoL is de ined as “indi idu- als’ pe cep ion o hei posi ion in li e in he con ex o he cul u e and alue sys ems in which hey li e and in ela ion o hei goals, expec a ions, s anda ds and conce ns” [ 9 ]. App aising a pa ien ’s QoL allows heal hca e p o essionals o iden i y heal h dimensions a isk and also o design indi idualized in e en ions o main ain and/o imp o e he pa ien /ca egi e QoL du ing ea men wi h AKOA [ 10 , 11 ]. In addi ion, acco ding o An ono sky [ 12 ], a sel -e icacy app oach o heal h can lead o an imp o emen in he pa- ien s’ unde s anding, sel -managemen , and meaning ulness o hei li e, hus gene a ing a highe le el o heal h. Acco ding o An ono sky’s salu ogenic model [ 12 ], app op ia e use o he esou ces a ailable om he en i onmen p o ides oppo uni ies o pa ien s o ace challenges and eco e om ad e si y; he abili y o make app op ia e use o hese esou ces and, subsequen ly, ac cons uc i ely h ough li e e en s is known as he sense o cohe ence (SOC) [ 13 ]. A good SOC has been ound o be posi i ely ela ed o be e heal h ou comes ac oss a ange o pa ien popula ions, including pa ien s wi h ca diac diso de s [14,15]. P e ious s udies ha e iden i ied a signi ican associa ion be ween he QoL and SOC in a ange o ch onic pa hologies, namely cance [ 16 ]; end-s age enal disease [ 17 ]; and ca dio ascula diso de s, including pa ien s unde going angioplas y p ocedu es [18] and hose wi h ch onic hea ailu e [ 19 ], a ial ib illa ion [ 20 ], and congeni al hea disease [ 21 ]. A posi i e co ela ion be ween he QoL and SOC has also been es ablished in communi y- dwelling olde people [ 22 , 23 ]. Howe e , less is known abou he ela ionship be ween he gene al and speci ic QoL and SOC, conside ing he speci ic QoL as a measu emen o QoL in pa ien s on long- e m ea men wi h AKOA. The e o e, he aim o his s udy was o analyze he ela ionship be ween he gene al and speci ic QoL and SOC in pa ien s on long- e m ea men wi h AKOA. 2. Ma e ials and Me hods 2.1. Design A c oss-sec ional design was used o in es iga e he co ela ion be ween he gene al and speci ic QoL and SOC in a sample o pa ien s on ea men wi h an i i amin KOA. 2.2. Pa icipan s and S udy Loca ion This s udy was ca ied ou in a p ima y ca e cen e in he Za agoza Ci y Cen e , Spain, which se es a popula ion o 32,862 adul inhabi an s (16,659 men and 20,557 women). The a ge popula ion comp ised all he pa ien s on ea men wi h AKOA (n= 244) who me he selec ion c i e ia. The sample size was de e mined ollowing Mi a Tamayo’s ecommenda ions o he applica ion o he Spanish e sion o he WHO quali y-o -li e scale (WHOQOL-BREF) [24], esul ing in a minimum sample o 75 pa icipan s. A o al o 85 pa ien s on ea men wi h AKOA we e ec ui ed o pa icipa e in his s udy. The inclusion c i e ia o ake pa in his in es iga ion we e (1) communi y-dwelling adul s (aged 18 o o e ), (2) on ea men wi h AKOA, (3) managed a he s udy loca ion, (4) and adhe en o ea men as measu ed by he Mo isky Medica ion Adhe ence Scale in i s Spanish e sion [ 25 ]. We excluded pa ien s who had commenced ea men wi h In . J. En i on. Res. Public Heal h 2021,18, 1668 3 o 15 AKOA less han 90 days be o e da a collec ion, hose who had di icul y communica ing in Spanish, and hose who e used o gi e in o med consen . We did no exclude any pa ien s based on he numbe o como bidi ies. 2.3. Ins umen s o Da a Collec ion We designed an ad hoc ques ionnai e on sociodemog aphic and clinical cha ac e is ics, including he ollowing a iables: sex, age, le el o educa ion, employmen s a us, ma i al s a us, li ing a angemen , pa icipa ion in housewo k ac i i ies, and ime since ea men wi h AKOA. We used he Spanish e sion o he WHOQOL-BREF o measu e he gene al QoL in ou sample [ 26 ]. This scale comp ises 24 i ems classi ied in o ou domains, namely physical, psychological, social ela ionships, and en i onmen al QoL, and wo ques ions o measu e he esponden s’ sel -pe cep ions o hei QoL (i em 1) and o hei gene al heal h (i em 2). I is measu ed on a 5-poin Like scale, wi h highe sco es indica ing a highe sel -pe cep ion o he QoL. The OA- ea men -speci ic QoL ques ionnai e was o iginally de eloped by Saw- icki [ 27 ] in 1999 and was ansla ed and alida ed o use in a Spanish popula ion by Sánchez González e al. [ 28 ] in 2004. This ool measu es he QoL in a popula ion on ea men wi h OA and comp ises 32 i ems di ided in o i e dimensions: (1) ea men sa is ac ion, (2) sel -managemen , (3) psychological dis ess, (4) limi a ions in daily ac i i- ies, and (5) impac on social ac i i ies. The OA- ea men -speci ic QoL ques ionnai e is sel -adminis e ed and is measu ed on a 6-poin Like scale, wi h esponse op ions anging om 1 ( o al disag eemen ) o 6 ( o al ag eemen ). Highe mean sco es indica e a be e QoL in dimensions 1 and 2, and lowe mean sco es indica e a wo se QoL in dimensions 3, 4, and 5. This ques ionnai e showed good in e nal consis ency o he o al scale ( α = 0.82) and o each dimension sepa a ely [28]. The SOC scale is a sel -assessmen ques ionnai e o iginally de eloped by An ono sky [ 29 ] o measu e he global o ien a ion o he pe sonali y, which acili a es an adap i e esponse o daily-li e p oblems and s ess ul si ua ions. In his s udy, we used he Spanish e sion o he SOC scale alida ed by Vi ués-O ega e al. [ 30 ] in 2007. I consis s o 13 i ems classi ied in o h ee dimensions: (1) comp ehensibili y (5 i ems), (2) manageabili y (4 i ems), and (3) meaning ulness (4 i ems). This ques ionnai e is sel - adminis e ed, and i is measu ed on a 7-poin Like scale anging om 1 (ne e o a ely) o 7 ( e y o en o always). 2.4. Da a Analysis A desc ip i e analysis was conduc ed using he mean and s anda d de ia ion (SD) o he quan i a i e a iables and equencies and pe cen ages o he quali a i e a iables. The di e ences be ween g oups we e analyzed using S uden ’s - es and Mann–Whi ney U es , applying he Bon e oni co ec ion o mul iple compa isons. A co ela ion analysis o he measu emen ins umen s, using he Pea son co ela ion coe icien , was applied. Fi- nally, s epwise mul iple eg essions we e pe o med in o de o de e mine he ela ionship be ween he signi ican p edic o alues o each WHOQOL-BREF dimension. Da a codi i- ca ion, p ocessing, and analysis we e comple ed using he so wa e S a is ical Package o he Social Science (SPSS) e sion 22 o Windows (IBM Co p., Chicago, IL, USA), accep ing a le el o signi icance o p< 0.05. 2.5. E hical Conside a ions The in es iga ion adhe ed o he p inciples ou lined in he Decla a ion o Helsinki [ 31 ]. All he pa icipan s included in he s udy we e in o med abou he s udy’s aims and p ocedu es and ga e hei in o med consen o pa icipa e. The esea ch p o ocol was au ho ized by he di ec i e manage s o A agón’s P ima y Ca e Depa men and was app o ed by he Clinical Resea ch E hics Commi ee o A agón (C.P.—C.I. PI18/0177). In . J. En i on. Res. Public Heal h 2021,18, 1668 4 o 15 3. Resul s A o al o 85 pa ien s comple ed he ques ionnai es. The sociodemog aphic cha ac e - is ics o ou sample a e desc ibed in Table 1. The majo i y o ou pa icipan s we e men (60%), wi h a mean age o 76.24 yea s (SD: 10.7 yea s). Nea ly hal o ou pa icipan s we e educa ed o he p ima y school le el; he emaining pa icipan s we e educa ed o he seconda y school o uni e si y le el, and only i e o ou pa ien s said ha hey had no s udied. Mos o ou pa ien s we e e i ed (90.6%), and jus o e hal o ou sample we e ma ied. Wi h ega d o hei li ing a angemen s, 22.4% o ou pa ien s li ed alone, 43.5% li ed wi h hei pa ne s, and 31.8% li ed wi h ela i es o he han hei pa ne s. Almos hal (47.1%) o ou pa icipan s said ha hey con ibu ed o housewo k asks. The mean numbe o mon hs on ea men wi h AKOA was 74.08 (SD: 62.53). Table 1. Sociodemog aphic cha ac e is ics (n= 85). Va iable Ca ego y n(%) Sex Male 51 (60%) Female 34 (40%) Age Less han 80 yea s 44 (51.8%) 80 yea s o mo e 41 (48.2%) Le el o educa ion P ima y school o below 47 (55.3%) Seconda y school o abo e 38 (44.7%) Employmen s a us Re i ed 77 (90.6%) Employed 8 (9.4%) Ma i al s a us Ma ied 45 (52.9%) Single o widowed 40 (47.1%) Li ing a angemen Li ing wi h pa ne 37 (43.5%) Li ing alone o wi h ela i es o he han pa ne 48 (56.5%) Pa icipa ion in housewo k Yes 40 (47.1%) No 45 (52.9%) Leng h o ea men wi h AKOA Less han 5 yea s 43 (50.6%) 5 yea s o mo e 42 (49.4%) The associa ions be ween he sociodemog aphic cha ac e is ics o ou pa icipan s and he esul s om he WHOQOL-BREF ques ionnai e a e p esen ed in Table 2. We obse ed ha he pa ien s aged less han 80 yea s and hose who we e educa ed o a leas he seconda y school le el p esen ed a highe QoL in he physical domain (p< 0.01). A highe QoL in he psychological domain was obse ed in pa ien s aged less han 80 yea s old (p< 0.01), ma ied pa ien s (p< 0.05), and hose who li ed wi h hei pa ne s (p< 0.01). People who we e unemployed epo ed a lowe QoL in he social domain (p< 0.05). In he en i onmen al domain, he pa icipan s who we e ma ied (p< 0.05), hose who did no pe o m any housewo k asks (p< 0.05), and hose who had been on ea men o less han i e yea s p esen ed a highe QoL (p< 0.05). I is impo an o no e ha a e applying he Bon e oni co ec ion, only he associa ion be ween age and he QoL in he psychological domain emained signi ican . The esul s om he OA- ea men -speci ic QoL ques ionnai e a e p esen ed in Table 3 . We obse ed signi ican di e ences in he sel -managemen domain, wi h be e esul s o he men (p< 0.01), he pa icipan s who we e educa ed o he seconda y school le el o abo e (p< 0.05), and hose who we e ma ied (p< 0.05). The pa ien s who li ed wi h hei pa ne s, as opposed o hose li ing alone o wi h ela i es o he han hei pa ne s, expe ienced ewe limi a ions in daily ac i i ies (p< 0.05). We did no ind any signi ican di e ences be ween g oups o he ea men sa is ac ion, impac on social ac i i ies, and psychological dis ess domains. A e he Bon e oni co ec ion, none o he associa ions emained signi ican . In . J. En i on. Res. Public Heal h 2021,18, 1668 5 o 15 Table 4shows he esul s om he SOC scale. We ound a signi ican associa ion be ween he leng h o ea men wi h AKOA (less han i e yea s) and he manageabili y (p< 0.01) and meaning ulness dimensions (p< 0.05). We did no iden i y any addi ional signi ican di e ences be ween g oups in he manageabili y dimension. Howe e , we obse ed ha he pa ien s who we e aged 80 yea s o less achie ed be e esul s in he meaning ulness dimension (p< 0.01). Signi ican di e ences we e obse ed in he comp ehensibili y dimension, wi h ma ied pa ien s (p< 0.05), hose who li ed wi h hei pa ne s (p< 0.01), and hose who did no ake pa in housewo k asks (p< 0.01) achie ing be e esul s. All o he associa ions emained signi ican wi h he excep ion o ma i al s a us–comp ehensibili y and ea men leng h–meaning ulness a e he Bon e oni co ec ion. We analyzed he co ela ions be ween he h ee ques ionnai es (Table 5). The ou domains o he WHOQOL-BREF we e associa ed wi h he OA- ea men -speci ic QoL ques ionnai e dimension ea men sa is ac ion. We did no ind any signi ican associ- a ions be ween he WHOQOL-BREF and he SOC dimensions. We iden i ied a posi i e co ela ion be ween he sel -managemen domain om he OA- ea men -speci ic QoL ques ionnai e and he psychological domain om he WHOQOL-BREF ques ionnai e; sel -managemen was also posi i ely co ela ed wi h he comp ehensibili y dimension om he SOC scale. Wi h ega d o he impac on social ac i i ies, as measu ed by he OA- ea men -speci ic QoL ques ionnai e, we iden i ied signi ican in e se co ela ions wi h he physical, psychological, and social WHOQOL-BREF domains and wi h he manageabili y and comp ehensibili y SOC subscales. Limi a ions in daily ac i i ies and psychological dis ess we e in e sely co ela ed wi h he ou domains o he WHOQOL-BREF ques ion- nai e and he h ee SOC subscales. We obse ed a signi ican posi i e associa ion be ween he WHOQOL-BREF’s physical, psychological, and en i onmen al domains and he SOC scale. Mul i a ia e eg ession was pe o med o p edic he alues o each WHOQOL-BREF dimension (Table 6). Fo he physical domain, he signi ican equa ion was p edic ed by OA- ea men -speci ic QoL-Gene al T ea men Sa is ac ion (GTS), SOC-Comp, le el o educa ion, SOC-Meaning, and SOC-Man ( 2 = 0.49), while he psychological domain equa ion was based on SOC-Comp, OA- ea men -speci ic QoL-Dis ess (OAQoL-D), and age ( 2 = 0.54). Fo he social domain, he signi ican equa ion was based on OAQoL-D and employmen ( 2 = 0.25), and he p edic o model o he en i onmen al dimension was based on he alues o SOC-Meaning, SOC-Comp, and OAQoL-GTS ( 2= 0.30). In . J. En i on. Res. Public Heal h 2021,18, 1668 6 o 15 Table 2. Associa ions be ween he pa icipan s’ sociodemog aphic cha ac e is ics and he esul s om he Wo ld Heal h O ganiza ion quali y-o -li e scale (WHOQOL-BREF) ques ionnai e. Va iable Ca ego y n(%) WQ-Ph WQ-Psy WQ-Social WQ-En Mean (SD) d ppBMean (SD) d ppBMean (SD) d pBCo ec ed Mean (SD) d ppB Sex 1Male 51 (60%) 13.17 (2.08) 83 0.08 0.48 14.56 (1.78) 83 0.14 0.70 13.15 (2.07) 83 0.15 0.72 14.73 (1.66) 83 0.71 0.99 Female 34 (40%) 12.18 (3.01) 13.88 (2.51) 13.88 (2.55) 14.59 (1.77) Age 1Less han 80 yea s 44 (51.8%) 13.36 (2.58) 83 0.025 0.18 14.89 (1.75) 83 0.006 0.047 13.73 (2.38) 83 0.23 0.87 14.86 (1.68) 83 0.28 0.93 80 yea s mo e 41 (48.2%) 12.14 (2.33) 13.64 (2.29) 13.14 (2.16) 14.46 (1.70) Le el o educa ion 1P ima y school o below 47 (55.3%) 12.16 (2.76) 83 0.009 0.07 14.13 (2.34) 83 0.43 0.99 13.70 (2.35) 83 0.25 0.89 14.65 (1.81) 83 0.89 1 Seconda y school o abo e 38 (44.7%) 13.53 (1.98) 14.49 (1.80) 13.12(2.18) 14.70 (1.57) Employmen 2Re i ed 77 (9.4%) 12.55 (2.37) -0.08 0.49 14.18 (2.05) -0.28 0.92 13.23 (2.13) -0.029 0.20 14.58 (1.58) -0.22 0.86 Employed 8 (90.6%) 14.93 (3.14) 15.33 (2.52) 15.50 (2.85) 15.56 (2.53) Ma i al s a us 1Ma ied 45 (52.9%) 13.17 (2.16) 83 0.13 0.67 14.80 (1.86) 83 0.017 0.13 13.36 (2.00) 83 0.74 115.04 (1.49) 83 0.030 0.21 Single o widowed 40 (47.1%) 12.33 (2.85) 13.72 (2.25) 13.53 (2.59) 14.25 (1.83) Li ing a angemen 1Li ing wi h pa ne 37 (43.5%) 13.24 (2.22) 83 0.13 0.67 14.97 (1.77) 83 0.008 0.06 13.51 (1.89) 83 0.79 115.05 (1.49) 83 0.06 0.39 No li ing wi h pa ne 48 (56.5%) 12.42 (2.70) 13.76 (2.22) 13.39 (2.56) 14.28 (1.80) Pa icipa ion in homewo k ac i i ies 1 Yes 40 (47.1%) 12.54 (2.29) 83 0.43 0.98 13.92 (1.78) 83 0.12 0.64 13.00 (2.33) 83 0.09 0.52 14.28 (1.64) 83 0.042 0.29 No 45 (52.9%) 12.98 (2.73) 14.62 (2.34) 13.84 (2.19) 15.02 (1.68) T ea men leng h 1Less han 5 yea s 43 (50.6%) 13.18 (2.80) 83 0.13 0.67 14.70 (1.94) 83 0.07 0.44 13.83 (2.54) 83 0.11 0.61 15.07 (1.75) 83 0.027 0.19 5 yea s o mo e 42 (49.4%) 12.35 (2.16) 13.87 (2.22) 13.05 (1.94) 14.26 (1.55) To al 85 (100%) 12.77 (2.52) - 14.29 (2.11) - 13.44 (2.28) - 14.67 (1.69) - 1 S uden ’s - es ; 2 Mann–Whi ney’s U es ; WQ-Ph: physical domain; WQ-Psy: psychological domain; WQ-Social: social domain; WQ-En : en i onmen al domain; p: aw p- alue; p B :p- alue a e he Bon e oni co ec ion. In . J. En i on. Res. Public Heal h 2021,18, 1668 7 o 15 Table 3. Associa ions be ween he pa icipan s’ sociodemog aphic cha ac e is ics and he esul s om he o al an icoagulan (OA)- ea men -speci ic QoL ques ionnai e. Va iable Ca ego y n(%) T ea men Sa is ac ion Sel -Managemen Psychological Dis ess Limi a ions in Daily Ac i i ies Impac on Social Ac i i ies Mean (SD) d ppBMean (SD) d ppBMean (SD) d ppBMean (SD) d ppBMean (SD) d ppB Sex 1Male 51 (60%) 4.79 (0.76) 83 0.25 0.89 4.71 (0.61) 83 0.009 0.069 1.96 (0.66) 83 0.94 12.09 (0.67) 83 0.12 0.64 3.00 (0.66) 83 0.10 0.57 Female 34 (40%) 4.57 (0.96) 4.26 (0.93) 1.97 (0.90) 2.36 (0.92) 3.30 (0.99) Age 1Less han 80 yea s 44 (51.8%) 4.77 (0.86) 83 0.42 0.98 4.48 (0.88) 83 0.55 0.99 2.02 (0.75) 83 0.48 0.99 2.26 (0.79) 83 0.44 0.99 3.11 (0.75) 83 0.93 1 80 yea s o mo e 41 (48.2%) 4.63 (0.82) 4.58 (0.66) 1.90 (0.77) 2.13 (0.78) 3.13 (0.88) Le el o educa ion 1 P ima y school o below 47 (55.3%) 4.70 (0.87) 83 0.99 14.36 (0.92) 83 0.029 0.21 2.04 (0.86) 83 0.28 0.92 2.10 (0.72) 83 0.21 0.85 3.04 (0.85) 83 0.32 0.95 Seconda y school o abo e 38 (44.7%) 4.70 (0.82) 4.73 (0.51) 1.87 (0.61) 2.32 (0.85) 3.22 (0.76) Employmen 2Re i ed 77 (9.4%) 4.71 (0.82) - 0.87 14.49 (0.80) - 0.15 0.72 1.99 (0.78) - 0.39 0.98 2.18 (0.75) - 0.60 0.99 3.08 (0.82) - 0.26 0.91 Employed 8 (90.6%) 4.60 (1.14) 4.91 (0.40) 1.70 (0.49) 2.43 (1.09) 3.47 (0.73) Ma i al s a us 1Ma ied 45 (52.9%) 4.75 (0.73) 83 0.57 0.99 4.68 (0.58) 83 0.049 0.33 1.97 (0.62) 83 0.93 12.10 (0.78) 83 0.19 0.81 3.02 (0.74) 83 0.23 0.88 Single o widowed 40 (47.1%) 4.65 (0.96) 4.35 (0.93) 1.96 (0.90) 2.32 (0.78) 3.24 (0.89) Li ing a angemen 1 Li ing wi h pa ne 37 (43.5%) 4.83 (0.72) 83 0.19 0.81 4.67 (0.61) 83 0.12 0.64 1.95 (0.60) 83 0.90 11.98 (0.63) 83 0.020 0.14 2.95 (0.71) 83 0.09 0.53 No li ing wi h pa ne 48 (56.5%) 4.60 (0.92) 4.42 (0.88) 1.97 (0.87) 2.37 (0.85) 3.25 (0.87) Pa icipa ion in housewo k asks 1 Yes 40 (47.1%) 4.63 (0.95) 83 0.49 0.99 4.38 (0.91) 83 0.10 0.57 2.09 (0.90) 83 0.14 0.70 2.36 (0.82) 83 0.07 0.44 3.19 (0.88) 83 0.49 0.99 No 45 (52.9%) 4.76 (0.74) 4.66 (0.62) 1.84 (0.58) 2.05 (0.73) 3.06 (0.76) T ea men leng h 1Less han 5 yea s 43 (50.6%) 4.74 (0.90) 83 0.64 0.99 4.42 (0.92) 83 0.20 0.83 1.86 (0.64) 83 0.19 0.81 2.12 (0.78) 83 0.36 0.97 3.09 (0.82) 83 0.69 0.99 5 yea s o mo e 42 (49.4%) 4.66 (0.79) 4.64 (0.60) 2.07 (0.85) 2.28 (0.78) 3.16 (0.81) To al 85 (100%) 4.70 (0.84) - 4.53 (0.78) - 1.96 (0.76) - 2.20 (0.78) - 3.12 (0.81) - 1S uden ’s - es ; 2Mann–Whi ney’s U es ; p: aw p- alue; pB:p- alue a e he Bon e oni co ec ion. In . J. En i on. Res. Public Heal h 2021,18, 1668 8 o 15 Table 4. Associa ions be ween he pa icipan s’ sociodemog aphic cha ac e is ics and he esul s om he sense-o -cohe ence (SOC) scale. Va iable Ca ego y n(%) SOC-Manageabili y SOC-Comp ehensibili y SOC-Meaning ulness Mean (SD) d ppBMean (SD) d ppBMean (SD) d ppB Sex 1Male 51 (60%) 5.14 (0.86) 83 0.79 1 5.08 (0.90) 83 0.06 0.39 5.09 (0.83) 83 1 1 Female 34 (40%) 5.08 (1.16) 4.67 (1.05) 5.09 (1.93) Age 1Less han 80 yea s 44 (51.8%) 5.12 (0.88) 83 0.96 1 4.84 (1.06) 83 0.45 0.99 5.37 (0.88) 83 0.003 0.024 80 yea s o mo e 41 (48.2%) 5.11 (1.09) 5.00 (0.89) 4.79 (0.85) Le el o educa ion 1P ima y school o below 47 (55.3%) 5.15 (1.10) 83 0.71 0.99 4.91 (1.11) 83 0.98 1 4.94 (0.90) 83 0.09 0.53 Seconda y school o abo e 38 (44.7%) 5.07 (0.82) 4.92 (0.80) 5.27 (0.90) Employmen 2Re i ed 77 (9.4%) 5.13 (1.00) -0.59 0.99 4.92 (0.97) -0.99 1 5.05 (0.87) -0.11 0.61 Employed 8 (90.6%) 5.00 (0.83) 4.88 (1.10) 5.50 (1.23) Ma i al s a us 1Ma ied 45 (52.9%) 5.19 (0.94) 83 0.43 0.98 5.16 (0.80) 83 0.014 0.11 5.24 (0.74) 83 0.11 0.61 Single o widowed 40 (47.1%) 5.03 (1.03) 4.65 (1.09) 4.92 (1.05) Li ing a angemen 1Li ing wi h pa ne 37 (43.5%) 5.22 (0.99) 83 0.38 0.97 5.26 (0.76) 83 0.003 0.024 5.07 (0.68) 83 0.89 1 No li ing wi h pa ne 48 (56.5%) 5.03 (0.98) 4.65 (1.05) 5.10 (1.06) Pa icipa ion in housewo k asks 1Yes 40 (47.1%) 4.99 (0.93) 83 0.29 0.93 4.61 (1.06) 83 0.005 0.039 5.19 (0.84) 83 0.34 0.96 No 45 (52.9%) 5.22 (1.02) 5.20 (0.81) 5.00 (0.97) T ea men leng h 1Less han 5 yea s 43 (50.6%) 5.40 (1.03) 83 0.006 0.047 5.07 (1.06) 83 0.15 0.73 5.31 (0.91) 83 0.023 0.17 5 yea s o mo e 42 (49.4%) 4.82 (0.85) 4.76 (0.87) 4.86 (0.86) To al 85 (100%) 5.11 (0.98) - 4.92 (0.98) - 5.09 (0.91) - 1S uden ’s - es ; 2Mann–Whi ney’s U es ; p: aw p- alue; pB:p- alue a e he Bon e oni co ec ion. In . J. En i on. Res. Public Heal h 2021,18, 1668 9 o 15 Table 5. Pea son’s co ela ions be ween he assessed dimensions. WQ-Ph WQ-Psy WQ- Social WQ-En OAQoL- GTS OAQoL-SE OAQoL- SSN OAQoL- DH OAQoL-D SOC-Man SO-Comp SO- Meaning WQ-Ph - WQ-Psy 0.601 ** - WQ-Social 0.429 ** 0.500 ** - WQ-En 0.575 ** 0.634 ** 0.534 ** - OAQoL-GTS 0.453 ** 0.299 ** 0.356 ** 0.303 ** - OAQoL-SE 0.263 * 0.176 0.043 0.143 0.025 - OAQoL-SSN −0.349 ** −0.231 * −0.253 * −0.184 −0.535 ** −0.090 - OAQoL-DH −0.322 ** −0.341 ** −0.314 ** −0.261 * −0.647 ** −0.161 0.660 ** - OAQoL-D −0.395 ** −0.509 ** −0.363 ** −0.322 ** −0.571 ** 0.059 0.557 ** 0.688 ** - SOC-Man 0.232 * 0.458 ** 0.187 0.257 * 0.178 0.057 −0.405 ** −0.398 ** −0.384 ** - SOC-Comp 0.436 ** 0.524 ** 0.253 * 0.383 ** 0.126 0.357 ** −0.256 * −0.364 ** −0.249 * 0.663 ** - SOC-Meaning 0.373 ** 0.431 ** 0.185 0.392 ** 0.087 −0.041 −0.076 −0.072 −0.253 * 0.340 ** 0.251 * - WQ-Ph: physical domain; WQ-Psy: psychological domain; WQ-Social: social domain; WQ-En : en i onmen al domain; OAQoL-GTS: gene al ea men sa is ac ion; OAQoL-SE: sel -e icacy; OAQoL-SSN: s ained social ne wo k; OAQoL-DH: daily hassles; OAQoL-D: dis ess; SOC-Man: manageabili y; SOC-Comp: comp ehensibili y; SOC-Meaning: meaning ulness; * p< 0.05; ** p< 0.01.