Psychosocial and clinical factors associated with poor self-care in patients with chronic heart failure

Abstract

Abstract Background Self care is a crucial factor in the education of patients with heart failure (HF) and directly impacts in the progression of the disease. Beyond heart failure related factors, the role of psychosocial determinants and its interaction with clinical aspects has not been fully explored. Aims The aim of the study was to analyze both clinical and psychosocial factors associated with poor self care in patients with chronic HF. Methods Self care was evaluated at baseline with the 9 item European HFR Self Care Behaviour Scale (9 item ESCBS). Scores were standardized and reversed from 0 (worst self care) to 100 (better self care). This study we analysed the associations between poor self care (defined as scores in the lower tertile of the 9 item ESCBS) with demographic, HF-related (clinical) and psychosocial factors in all patients at baseline. Results We included 1123 patients: mean age 72±11, 639 (60%) were male, mean LVEF 45±17 and 454 (40%) were in NYHA class III or IV. Mean score of the 9-item ESCBS was 69±28. In the clinical multivariate analyses HF-related factors associated with poor self-care were serum albumins level, ckd level and previous admission due to heart failure. In the psychosocial multivariate analyses poor social support, depressive symptoms and needing a caregiver were independently associated with poor self care. In combined models, only psychosocial factors were independently associated with poor self care whereas no clinical factors remain in the model. Conclusion Our study showed that psychosocial conditions are the main factors independently associated with poor self-care in patients with chronic heart failure Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): Hospital del Bellvitge