Factors Predicting Self-Care Behaviors Among Patients with Heart Failure
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Abstract
This predictive correlational study aimed to investigate the predictive power of cognitive illness perception, emotional responses, knowledge about the disease and frailty on self-care behaviors among 158 patients diagnosed with heart failure at a specialized tertiary hospital. Data collection was conducted through personal questionnaires, the Self - Care of Heart Failure Index Version 7.2 with the Cronbach's alpha coefficient at .82, the Brief Illness Perception Questionnaire, the Dutch of Heart Failure and Frailty Scale. Test-retest reliability with Intraclass correlation coefficients was measured at .94, .89 and .93, respectively. Descriptive statistics and logistics regression analysis were used to analyze the data.
The results revealed that about 63.90 of the samples were males at 68.50 years on average (S.D = 14.75). Most of the samples (67.70) had an overall score of good self-care behaviors. After the analysis, the predictive power, cognitive illness perception, emotional responses, knowledge about the disease and frailty were able to predict self-care behaviors among the patients with heart failure at 5.20 (Nagelkerke R2 = .052). The influencing variable to predict self-care behavior was having a high level of knowledge about the disease (OR = 2.5, 95% CI = 1.05 - 6.14, p-value = .037).
Summary: Patients with heart failure should receive thorough information regarding heart failure from physicians, nurses and multidisciplinary care teams, so that they can appropriately apply the information to promote self-care behaviors.
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References
Braunwald E. The war against heart failure: the Lancet lecture. The Lancet 2015;385(9970):812-24. doi: 10.1016/S0140-6736(14)61889-4.
Fang N, Jiang M, Fan Y. Ideal cardiovascular health metrics and risk of cardiovascular disease or mortality: a meta-analysis. The International Journal of Cardiology 2016;214:279-83. doi: 10.1016/j.ijcard.2016.03.210.
Vassileva CM, Ghazanfari N, Spertus J, McNeely C, Markwell S, Hazelrigg S. Heart failure readmission after mitral valve repair and replacement: five-year follow-up in the medicare population. The Annals of Thoracic Surgery 2014;98(5):1544-50. doi: 10.1016/j.athoracsur. 2014.07.040.
Heidenreich PA, Albert NM, Allen LA, Bluemke DA, Butler J, Fonarow GC, et al. Forecasting the impact of heart failure in the United States: a policy statement from the American heart association. Circulation Heart Failure 2013;6(3):606-19. doi: 10.1161/HHF.0b013e318291329a.
Reyes EB, Ha JW, Firdaus I, Ghazi AM, Phrommintikul A, Sim D, et al. Heart failure across Asia: same healthcare burden but differences in organization of care. The International Journal of Cardiology 2016;223:163-7. doi: 10.1016/j.ijcard.2016.07.256.
Suwanratsamee W, Pinyopasakul W, Charoenkitkarn V, Dumavibhat C. Symptom experiences, symptom management, and functional status in patients with heart failure. Thai Journal of Cardio-Thoracic Nursing 2013;24(1):1-16. (in Thai)
Riegel B, Dickson VV, Faulkner KM. The situation-specific theory of heart failure self-care: revised and updated. Journal of Cardiovascular Nursing 2016;31(3):226-35. doi: 10.1097/JCN.0000000000000244.
Riegel B, Jaarsma T, Lee CS, Stromberg A. Integrating symptoms into the middle-range theory of self-care of chronic illness. Advances in Nursing Science 2019;42(3):206-15. doi: ANS.0000000000000237.
Siabani S, Driscoll T, Davidson PM, Najafi F, Jenkins MC, Leeder SR. Self-care and its predictors in patients with chronic heart failure in western Iran. Journal of Cardiovascular Nursing 2016;31(1):22-30. doi: 10.1097/JCN.0000000000000211.
Leventhal H, Nerenz DR, Steele D. Illness representations and coping with health threats. Handbook of psychology and health volume IV social psychology aspects of health. London: Routledge; 2020. doi: 10.4324/9781003044307-9.
Reeder KM, Ercole PM, Peek GM, Smith CE. Symptom perceptions and self-care behaviors in patients who self-manage heart failure. Journal of Cardiovascular Nursing 2015;30(1):1-7. doi: 10.1097/JCN.0000000000000117.
MacInnes J. Relationships between illness representations, treatment beliefs and the performance of self-care in heart failure: a cross-sectional survey. European Journal of Cardiovascular Nursing 2013;12(6):536-43. doi: 10.1177/1474515112473872.
Morgan K, Villiers TA, Barker M, Mc GH. The contribution of illness perception topsychological distress in heart failure patients. BMC Psychology 2014;2(1):1-9. doi: 10.1186/s40359-014-0050-3.
Leventhal H, Diefenbach M, Leventhal E. Illness cognition: using common sense to understand treatment adherence and affect cognition interactions. Cognitive and Research 1992;16(1):143-63. doi: 10.1007/BF01173486.
Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. Journal of Psychosomatic Research 2006;60(6):631-7. doi: 10.1016/j.jpsychores.2005.10.020.
Woods L, Duff J, Roehrer E, Walker K, Cummings E. Representing the patient experience of heart failure through empathy, journey and stakeholder mapping. Patient Experience Journal 2019;6(1):55-62. doi: 10.35680/2372-0247.1324.
Van der Wal MH, Jaarsma T, Moser DK, Veldhuisen DJ. Development and testing of the Dutch heart failure knowledge scale. European Journal of Cardiovascular Nursing 2005;4(4):273-7. doi: 10.1016/j.ejcnurse.2005.07.003.
Massouh A, Skouri H, Cook P, Huijer HAS, Khoury M, Meek P. Self-care confidence mediate self-care maintenance and management in patients with heart failure. Heart Lung 2020;49(1):30-5. doi: 10.1016/j.hrtlng.2019.07.008.
Teeoutid W, Kunsongkeit W, Dungpaeng S. Factor influencing self-management behaviors of sodium restriction among congestive heart failure patients. Journal of Boromarajonani College of Nursing, Bangkok 2019;35(1):120-9. (in Thai)
Denfeld QE, Winters SK, Mudd JO, Hiatt SO, Lee CS. Identifying a relationship between physical frailty and heart failure symptoms. Journal of Cardiovascular Nursing 2018;33(1):1-7. doi: 10.1097/JCN.0000000000000408.
Uchmanowicz I, Wleklik M, Gobbens RJ. Frailty syndrome and self-care ability in elderly patients with heart failure. Clinical Interventions in Aging 2015;10(1):871-7. doi: 10.2147/CIA.S83414.
Son YJ, Shim DK, Seo EK, Seo EJ. Health literacy but not frailty predict self-care behaviors in patients with heart failure. International Journal Environmental Research and Public Health 2018;15(11):2474. doi: 10.3390/ijerph15112474.
Seid MA, Abdela OA, Zeleke EG. Adherence to self-care recommendations and associated factors among adult heart failure patients from the patients' point of view. PLoS One 2019;14(2):e0211768. doi: 10.1371/journal.pone.0211768.
Riegel B, Barbaranelli C, Carlson B, Sethares KA, Daus M, Moser DK, et al. Psychometric testing of revised self-care of heart failure index. Journal of Cardiovascular Nursing 2019;34(2):183-92. doi: 10.1097/JCN.0000000000000543.
Sowattanangoon N, Kotchabhakdi N, Petrie KJ. The influence of Thai culture on diabetes perceptions and management. Diabetes Research and Clinical Practice 2009;84(3):245-51. doi: 10.1016/j.diabres.2009.02.011.
Srisuk N, Cameron J, Ski CF, Thompson DR. Randomized controlled trial of family-based education for patients with heart failure and their carers. Journal of Advance Nursing 2017;73(4):857-70.
Morley JE, Malmstrom TK, Miller DK. A simple frailty questionnaire (frail) predicts outcomes in middle aged African Americans. Nutrition and Healthy Aging 2012;16(7):601-68. doi: 10.1007/s12603-012-0084-2.
Sugiura A, Kitahara H, Iwahana T, Suzuki N, Okada S, Miyauchi H, et al. Association of heart failure duration with clinical prognosis in advanced heart failure. Clinical Research in Cardiology 2020;109(3):350-7. doi: 10.1007/s00392-019-01515-w.
ConceiçÌo VFP, Mendes JB, Teodoro MF, Dahlman J. Validation of a behavioral marker system for rating cadet’s non-technical skills. International Journal on Marine Navigation and Safety of Sea Transportation 2019;13(1):89-96. doi: 10.12716/1001.13.01.08.
Nguyen BT, Chunlestskul K, Deoisres W. Factors predicting treatment adherence among patients with heart failure in Vietnam. Journal of Nursing and Health Care 2016;34(1):143-52. (in Thai)
Vidan MT, Sanchez E, Fernandez AF, Serra JA, Ortiz J, Bueno H, et al. FRAIL-HF, a study to evaluate the clinical complexity of heart failure in nondependent older patients: rationale, methods and baseline characteristics. Clinical Cardiology 2014;37(12):725-32. doi: 10.1002/clc.22345.