Abstract 13344: Do Heart Failure Patients’ Personal Priorities Influence Their Self-care Maintenance Behaviors?

Abstract

Introduction: The personal priorities of community dwelling patients with HF may influence their self-care behavior. However, clinicians are unsure of the personal priorities that influence self-care choices in patients with HF. Objective: To explore personal priorities ranked highest among HF patients with poor or excellent self-care behaviors. Methods: We conducted a cross sectional convergent mixed methods study of community dwelling patients with HF in the US, excluding those with significant cognitive impairment (MoCA score ≤22). All completed the Self-Care of HF Index v7.2 (scores standardized 0-100). Extreme case sampling was used to select people with poor self-care maintenance scores (≤60) or excellent self-care maintenance scores (≥80). In interviews, participants placed their personal and healthcare needs into the same imaginary bucket and then rank-order them from highest to lowest priority. Interview data was audio-recorded, transcribed verbatim and analysed using qualitative inductive analysis. Results: We enrolled 33 patients with HF (aged 42-82 years, 57% male, 45.5% black, 45.5% married, 54.6% unemployed). Sixteen patients were poor in self-care maintenance and 17 were excellent. Two themes representing HF patients’ personal priorities emerged: a) Healthcare (60.6%, N=20), and b) Family and Housing (36.4%, N=12). Patients who chose healthcare identified medications, insurance and living a longer life as important. As stated by one patient, “without your health you have nothing.” Patients who chose family and housing identified; 1) rent, mortgage, or real estate taxes and 2) food for their children and a roof over their head as most important. They explained by saying “ I have to have some place to live and the utilities ” and “ I can be in a card box, but I just wanna make sure they are fed .” Of those who chose healthcare as their priority, 12 (60%) had excellent self-care maintenance. Only 4 patients (33.3%) who chose family and housing had excellent self-care. Conclusion: HF patients who identify healthcare needs as their highest priority may be better at self-care maintenance. Identifying the priorities of patients with HF will help clinicians tailor discharge instructions.