Abstract 16880: Perceived Control Moderates the Relationship Between Fatigue and Self-Care in Patients With Heart Failure

Abstract

Introduction: Fatigue is associated with poor self-care in patients with heart failure (HF). However, factors of fatigue include not only physical factors but also psychological factors, making it difficult to manage. Perceived control refers to the ability to cope with threats and has a significant impact on self-care and fatigue. Hypothesis: We hypothesized that a higher perceived control would lead to better self-care, even if the level of fatigue was comparable. This study aimed to determine whether the perceived control moderates the relationship between fatigue and self-care in patients with HF. Methods: In this cross-sectional study, outpatients with HF (n = 165, 78.8% male, mean age = 69.5 years) completed an assessment of fatigue using the Brief Fatigue Inventory (BFI) and perceived control using the Control Attitude Scale Revised (CAS-R). Participants were categorized into four groups with High (H) and Low (L), H/H, H/L, L/H, and L/L, using the median of BFI and CAS-R scores. Self-care was measured using the Self-Care of HF Index (SCHFI v 6.2), which consists of three subscales, maintenance (adherence to treatment), management (management of symptoms) and confidence. All SCHFI scores were standardized (0–100). A higher score indicates better self-care. Analysis of variance was used to examine differences in four groups using the SCHFI scores. Results: There was a significant difference in SCHFI-maintenance (p = 0.018), especially between H/L and L/H (61.8± 17.3 vs. 70.8 ± 17.3, p = 0.026). Additionally, H/H tended to be higher than H/L (71.3 ± 11.73 vs. 61.8 ± 17.3, p = 0.069). There was a significant difference in SCHFI-management (p <0.001). H/H was significantly higher than H/L (60.1 ± 18.6 vs. 38.3 ± 22.5, p = 0.000), and L/H was significantly higher than L/L (53.3 ± 23.8 vs. 33.3 ±22.9, p <0.001). Similarly, significant differences were found in SCHFI-confidence (p <0.001). H/H was significantly higher than H/L (47.2 ± 21.6 vs. 28.8 ± 15.1, p < 0.001), and L/H was significantly higher than L/L (50.2 ± 21.6 vs. 22.8 ± 10.7, p <0.001). Conclusions: Perceived control might moderate the relationship between fatigue and self-care. Interventions for HF self-care require improvements in perceived control as well as physical factors, such as symptoms.