Validity of Self-reported Self-Care Assessment and Determinants of Self-Care Practices in Older Patients with Heart Failure

Abstract

Background: Self-care as a disease management strategy in heart failure (HF) is important for the prevention of rehospitalisation, but it is difficult to assess and does not always reflect actual self-care practices. This study aimed to compare self-reported self-care assessments and actual self-care practices in older patients with HF and examine factors influencing self-care performance. Methods: We included 64 patients with HF aged ≥65 years who had been hospitalised and prescribed rehabilitation with stable symptoms between April 2019 and September 2020. We assessed the B-type natriuretic peptide levels and New York Heart Association (NYHA) classification, Short Physical Performance Battery (SPPB), grip strength, and the Japanese version of the Montreal Cognitive Assessment (MoCA-J). We used the European Heart Failure Self-care Behaviour Scale (EHFScBS) to assess self-care behaviour in patients with HF. The patients filled in a self-assessment chart during their stay, which was used to work out the self-care implementation rate. Results: No significant correlation between the self-care implementation rate and the EHFScBS was identified (r= −0.160, p=0.207). Multiple regression analysis of factors associated with the rate of self-care and EHFScBS revealed that age, NYHA classification, SPPB and MoCA-J scores were significantly associated with the rate of self-care; however, no factors were associated with EHFScBS. The results were similar irrespective of the presence or absence of cognitive decline. Conclusion: In older patients with HF, the self-reported assessment of self-care did not reflect actual self-care performance. A reliable self-care behaviour scale needs to be developed.