Predictors of Better Self-Care in Patients with Heart Failure after Six Months of Follow-Up Home Visits

Melina Maria Trojahn,Cláudia Motta Mussi,Eneida Rejane Rabelo-Silva,Vânia Naomi Hirakata,Alexandra Nogueira Mello Lopes,Karen Brasil Ruschel,Emiliane Nogueira De Souza

doi:10.1155/2013/254352

Abstract

This study aimed to examine the predictors of better self-care behavior in patients with heart failure (HF) in a home visiting program. This is a longitudinal study nested in a randomized controlled trial (ISRCTN01213862) in which the home-based educational intervention consisted of a six-month followup that included four home visits by a nurse, interspersed with four telephone calls. The self-care score was measured at baseline and at six months using the Brazilian version of the European Heart Failure Self-Care Behaviour Scale. The associations included eight variables: age, sex, schooling, having received the intervention, social support, income, comorbidities, and symptom severity. A simple linear regression model was developed using significant variables (P ≤ 0.20), followed by a multivariate model to determine the predictors of better self-care. One hundred eighty-eight patients completed the study. A better self-care behavior was associated with patients who received intervention (P < 0.001), had more years of schooling (P = 0.016), and had more comorbidities (P = 0.008). Having received the intervention (P < 0.001) and having a greater number of comorbidities (P = 0.038) were predictors of better self-care. In the multivariate regression model, being in the intervention group and having more comorbidities were a predictor of better self-care.

Highlights

Self-care in heart failure (HF) is defined as positive behaviors leading to decisions and actions that an individual can take to help maintain clinical stability and cope with the disease [1]
This is a longitudinal study nested in an randomized controlled trial (RCT) called HELEN-I (ISRCTN01213862), whose primary aim was to verify the effect of a nursing educational intervention consisting of home visits and phone calls on patients’ knowledge of the disease, self-care, and adherence to treatment
Ischemic heart disease was the most common etiology of HF, and most patients were in New York Heart Association (NYHA) functional class III

Summary

Introduction

Self-care in heart failure (HF) is defined as positive behaviors leading to decisions and actions that an individual can take to help maintain clinical stability and cope with the disease [1]. Studies indicate that the inability of patients to recognize signs and symptoms of congestive episodes and the lack of knowledge and poor adherence to treatment, components that are considered self-care measures, are precipitating factors leading to decompensation of HF [2,3,4,5]. Within this context, all self-care behaviors appear to be directly related to motivation, habits, and sociodemographic and clinical characteristics, factors that may affect the way individuals live their lives [1, 6,7,8].

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