The relation between motivational support of partners and self-care behavior in patients with chronic heart failure

Abstract

Purpose: Social support, mostly provided by partners of Heart Failure patients, is known to be associated with positive health outcome in HF patients. Behavioral models suggest that social support has an impact through the influence of health behaviors. Partners of HF patients provide motivational support by encouraging patients to comply with their HF treatment regimen. In this study we hypothesized that motivational support of partners would be positively associated with self-care in HF patients. Method: Using a cross-sectional design, self-care in HF patients was measured with the European Hear Failure Self-care Behavior scale containing of 12 items measuring different aspects of self-care (EHFScB-12). Support of partners was measured with the Dutch Objective Burden Inventory (DOBI) measuring the amount of different kinds of support as reported by partners. The DOBI contains 38 items in total, in this study the subscale motivational support was used. The study population consisted of HF patients (and their partners) that participated in the Dutch COACH trial on the effects of education and counseling. Patients and partners were asked to complete a questionnaire while at home, 12 months after the index hospitalization. Results: In total 394 HF patients (44% NYHA III-IV, 24% female, mean age 67 (sd 11) and their 394 partners (76% female, mean age 67 (sd 12)) completed the questionnaire. The total score on self-care behavior in HF patients was 23 (range 12-60, sd 5.7). Partners provided motivational support with a mean score of 1.4 (range 1-3, sd 0.4). The amount of motivational support provided by partners was not associated with the level of self-care in the HF patients (Spearman's rho 0.08, p=0.12). Furthermore, no significant single item correlations between e.g. motivating my partner to adhere to prescriptions and I eat a low salt diet were found. Conclusion: Partners of HF patients report their efforts in trying to support patients to comply with their HF treatment regimen. However, this support does not seem to affect patient's self-care behavior. Further research is necessary to gain insight in effective support strategies in patients and families coping with HF.