Model construction of self-management behavior in senile patients with chronic heart failure based on AMOS

Abstract

Objective To build a model of self-management behavior for senile patients with chronic heart failure (CHF) based on Bandura's self-efficacy theory and Clark's chronic disease self-regulation model aged CHF patients and to provide scientific evidence for formulating self-management interventions and plans for senile CHF patients. Methods Totally 881 CHF patients were investigated in 30 hospitals from 6 districts of Shanghai from December 2014 to March 2016. The statistical software AMOS 21.0 was used to conduct the path analysis, include various influencing factors, and build systematically an equation model demonstrating the internal mechanism of self-management behaviors. Results The score of self-management of aged CHF patients was (50.2±9.8) . Self-concept, per capita income, heart function grading, avoidance as response, self-care ability, quality of life, resignation as response and education level were included into the multiple regression equation of self-management, and these variables accounted for 20.8% of the total variation. The structural equation model demonstrating the influencing factors of self-management for senile CHF patients fit better, and all path coefficients reached a significant level, suggesting that self-efficacy had only indirect effect on the self-management of senile CHF patients, while self-concept, per capita income, heart function grading, avoidance as response, self-care ability, quality of life, resignation as response and education level had both direct and indirect effect on their self-management. Conclusions The self-management of senile CHF patients remains at a medium and low level on the whole, and symptom management is the worst. This study has constructed a model demonstrating the internal mechanism of self-management behaviors in senile CHF patients, suggesting that medical staff should take targeted and systematic interventions according to the general condition of patients and their self-efficacy and self-concept to help improve their self-management level. Key words: Heart failure; Agde; Self-management; Structural equation model