Testing a model of patient characteristics, psychologic status, and cognitive function as predictors of self-care in persons with chronic heart failure
Open Access
- 1 September 2009
- journal article
- research article
- Published by Elsevier BV in Heart & Lung
- Vol. 38 (5), 410-418
- https://doi.org/10.1016/j.hrtlng.2008.11.004
Abstract
OBJECTIVE: Self-care is a key component in the management of chronic heart failure (CHF). Yet there are many barriers that interfere with a patient's ability to undertake self-care. The primary aim of the study was to test a conceptual model of determinants of CHF self-care. Specifically, we hypothesized that cognitive function and depressive symptoms would predict CHF self-care. METHODS: Fifty consecutive patients hospitalized with CHF were assessed for self-care (Self-Care of Heart Failure Index), cognitive function (Mini Mental State Exam), and depressive symptoms (Cardiac Depression Scale) during their index hospital admission. Other factors thought to influence self-care were tested in the model: age, gender, social isolation, self-care confidence, and comorbid illnesses. Multiple regression was used to test the model and to identify significant individual determinants of self-care maintenance and management. RESULTS: The model of 7 variables explained 39% (F [7, 42] 3.80; P = .003) of the variance in self-care maintenance and 38% (F [7, 42] 3.73; P = .003) of the variance in self-care management. Only 2 variables contributed significantly to the variance in self-care maintenance: age (P < .01) and moderate-to-severe comorbidity (P < .05). Four variables contributed significantly to the variance in self-care management: gender (P < .05), moderate-to-severe comorbidity (P < .05), depression (P < .05), and self-care confidence (P < .01). When cognitive function was removed from the models, the model explained less of the variance in self-care maintenance (35%) (F [6, 43] 3.9 1; P = .003) and management (34%) (F [6, 43] 3.71; P = .005). CONCLUSION: Although cognitive function added to the model in predicting both self-care maintenance and management, it was not a significant predictor of CHF self-care compared with other modifiable and nonmodifiable factors. Depression explained only self-care management. (Heart Lung (R) 2009;38:410-418.)This publication has 46 references indexed in Scilit:
- Depressive Symptoms Moderated the Effect of Chronic Illness Self-Management Training on Self-EfficacyMedical Care, 2008
- Cognitive influences on self-care decision making in persons with heart failureAmerican Heart Journal, 2007
- Beyond Comorbidity Counts: How Do Comorbidity Type and Severity Influence Diabetes Patients’ Treatment Priorities and Self-Management?Journal of General Internal Medicine, 2007
- Heart Disease and Stroke Statistics—2007 UpdateCirculation, 2007
- Assessment of Cognitive Function in Heart Failure PatientsEuropean Journal of Cardiovascular Nursing, 2006
- Hospitalized older peoples’ views of health and health promotionInternational Journal of Older People Nursing, 2006
- Vulnerabilities of patients recovering from an exacerbation of chronic heart failureAmerican Heart Journal, 2005
- Screening for mild cognitive impairment (MCI) utilizing combined mini‐mental‐cognitive capacity examinations for identifying dementia prodromesInternational Journal of Geriatric Psychiatry, 2002
- An Empirical Study of a Model of Self-Care in Chronic IllnessClinical Nurse Specialist, 1993
- A new method of classifying prognostic comorbidity in longitudinal studies: Development and validationJournal of Chronic Diseases, 1987