Abstract 12816: Changes in Self-Care and Quality of Life After Hospitalization for Coronary Heart Disease

Abstract

Background: Self-care is an important part of secondary prevention for patients with coronary heart disease (CHD). But, we know little about how CHD self-care influences quality-of-life (QOL) over time. Hypothesis: Changes in CHD self-care would be associated with changes in QOL. Aims: Identify distinct trajectories of change in self-care following a hospitalization for CHD that were associated with significant differences in QOL over time. Methods: Longitudinal study (Iceland). Patients completed surveys at hospital discharge and 6 months later. Self-care was measured with the Self-Care of CHD Inventory (maintenance and management scores = 0-100, higher=better) and QOL was measured with the SF-12 (physical and mental QOL = 0-100, higher=better). Growth mixture modeling was used to identify trajectories of CHD self-care behaviors. Results: A total of 373 patients (mean age 64.3±8.9, 79% male) completed the study. Two trajectories of CHD self-care were identified. The first one (57.2% of the sample - solid line - “Inadequate and Worsening”) had comparatively worse self-care at both timepoints; maintenance improved but management got significantly worse over time (-6.3±24.4 points, p=0.005). The second trajectory (42.8% of the sample - dashed line - “Adequate and Maintaining”) had comparatively better self-care at both timepoints; maintenance improved significantly (+5.0±16.2 points, p<0.001), and management was unchanged over time (+0.8±21.9 points, p=0.713). Participants in both trajectories had significant improvements in their physical and mental QOL (both p<0.001) over time ( Fig. 1 ). Participants in the first trajectory had comparatively worse physical and mental QOL at both timepoints (all p<0.05). Conclusion: Two distinct trajectories of self-care were identified and linked to significant differences in QOL following a hospitalization for CHD. Care models that focus on improving self-care skills might also improve QOL of patients with CHD.