Self-care Behaviors In Patients Research Articles

Measuring Importance of Physical Self-Care Behavior in Patients with Heart Failure: Validation and Reliability Analysis of IPSC-14 Item Scale

Heart failure (HF) is a complex clinical syndrome associated with increased disability, morbidity and mortality globally. HF is characterized by recurrent exacerbations and a high rate of hospital readmissions. Self-care is a crucial component of treatment. The way patients assess the importance of self-care may shed light on planning effective individualized interventions. The aim of this study was to conduct a validity and reliability analysis of the new 14-item IPSC scale, which measures how important HF patients consider their physical self-care behavior (IPSC, Importance of Physical Self-Care). The 14-item IPSC scale was created by the researchers to explore how important HF patients consider their physical self-care behavior. The validation of the IPSC scale included face and content validity, construct validity, internal consistency, repeatability and discriminant validity. Patients' characteristics were also included. In the present study, 52 hospitalized HF patients were enrolled, of whom 55.8% were female, 34.6% above 70 years old, 48.1% of NYHA class III and 32.7% suffered this illness from 6 to 10 years. The total IPSC score had a possible range of 14-56, with higher scores indicating a low importance of self-care. The descriptive statistics in the IPSC scale showed a mean score of 27.9 ± 4.9 and a median score of 29, indicating that HF patients evaluated self-care behavior as moderately important. All items were found to be statistically significantly correlated with total scale scores (p ≤ 0.05), with correlation coefficients rho > 0.250, indicating moderate to strong correlations and meaning that all items are important in the calculation of the final score (construct validity). The internal consistency of the items that constituted the total score was found to be high (Cronbach's a > 0.7). Furthermore, it was found that scores had high repeatability (p ≤ 0.001 and ICCs > 0.7). Regarding discriminant validity, a statistically significant association was observed between the importance of physical self-care behavior and both years suffering the illness (p = 0.007) and the NYHA class (p = 0.030). The 14-item IPSC scale is a reliable instrument that help nurses in clinical settings to gain a better and prompt understanding of the importance which patients invest in their physical self-care behavior.

The Effect of Diabetes Self-care Education through WhatsApp Virtual Messenger on the Self-care Behavior of Patients with Type 2 Diabetes: A Semi-experimental Study

Background and Objective: Immediate interventions are necessary to improve the self-care behaviors of diabetic patients. This study aimed to investigate the effect of diabetes self-care education through WhatsApp virtual messenger on the self-care behavior of diabetic patients. Materials and Methods: This semi-experimental study was conducted in Jiroft, Iran, in 2019, and included 96 patients with type 2 diabetes who met the inclusion criteria and were selected randomly and divided into intervention and control groups using simple random allocation (lottery). The educational content of self-care was sent to the intervention group by the researcher for 8 sessions of 60 minutes (2 sessions per week) through the WhatsApp virtual messenger. Summary of Diabetes Self Care Activities questionnaire was completed in two stages before and one month after the end of the intervention in both groups. The obtained data were analyzed in SPSS software (version 24) through descriptive (Mean±SD) and inferential statistics (ANCOVA). Results: Before and one month after the intervention, the overall score of self-care behaviors and the scores of such subscales as diet adherence, foot care, blood sugar control, and regular medication use, increased significantly in the intervention group (P<0.001); however, there was no significant change in the overall score of self-care behavior and its subscales in the control group (P>0.05). Conclusion: Implementation of the self-care education program through WhatsApp virtual messenger helps to improve the self-care behaviors of diabetes patients and can be used as an effective method in preventing the adverse consequences of diabetes.

Hubungan Health Locus Of Control Dengan Self-Care Behavior Pasien Diabetes Mellitus Tipe 2

Background: Diabetes Mellitus is a chronic metabolic disease characterized by an increase in glucose levels in the blood, so it is required to carry out a series of DM management independently with the aim of avoiding the risk of complications and controlling glucose levels in the blood. Health locus of control is a belief in controlling the good and bad of a person's health behavior.The objective: This research is to determine the relationship between health locus of control and self-care behavior of Diabetes Mellitus type 2 patients in working area of Penimbung public health centerMethods: The method uses a cross-sectional study design. The sample consisted of 81 respondents with purposive sampling method. Results: The results of the spearman rank correlation test showed that there was a significant relationship with positive strength between HLoC and self-care behavior (ρ-value 0.005).Conclusion: There was a significant relationship between the health locus of control and the self-care behavior of patients with Diabetes Meilitus type 2.Keywords: DM type 2; Health Locus Of Control; self-care behavior

Factors Associated With Self-Efficacy of Foot Self-Care Among Patients With Diabetes Attending a Tertiary Care Center in Saudi Arabia.

Several reports have shown self-efficacy to be a reliable way of predicting foot self-care behavior in patients with diabetes. However, at a global level in general, and in Saudi Arabia in particular, investigation of the factors related to self-efficacy in executing foot self-care continues to remain inadequate. This study endeavors to identify the factors associated with the self-efficacy of foot self-care among patients with diabetes in Saudi Arabia. From a tertiary diabetes care center in Saudi Arabia, 175 patients with diabetes were selected to participate in this cross-sectional study. Employing the Arabic version of the Foot Care Confidence Scale (FCCS), the principal end results and the sociodemographic, clinical, and psychosocial independent variables were collected and assessed. From the total reported FCCS score, the mean was found to be 28.1 ± 8.2. Multiple linear regression analysis indicated 2 independent factors were positively associated with a higher reported FCCS score; being middle-aged (< 60 years old) (β=0.31, P< .01) and having a higher score on the Foot Care Outcome Expectations Scale (FCOES) (β=0.36, P< .01). In conclusion, patients with diabetes in Saudi Arabia have a mild level of self-efficacy to perform the needed foot self-care. Therefore, this has turned the spotlight on the young or middle-aged < 60-year-old Saudi population with diabetes as the target group, making them the priority for future self-efficacy promotion programs to upgrade the level of foot self-care.

Comparison of the effect of acceptance and commitment therapy and reality therapy on the self-care of diabetes type II patients.

Self-care is one of the most important factors affecting the lives of people with chronic diseases such as diabetes. This study attempted to compare the effectiveness of acceptance and commitment therapy (ACT) and reality therapy on self-care in type II diabetes patients. It was a quasi-experimental study with pretest-post-test control group design. The statistical population included 100 patients referred to diabetes clinics in Torbat Heydariyeh, 2020-2021. Using available sampling method, 60 patients were selected and randomly assigned to three groups of 20 people (2 experimental groups and a control group). Data collection instrument included demographic information and standard diabetes self-care questionnaire. Data analysis was performed using analysis of covariance and Bonferroni post hoc test. The results showed that there was a significant difference between self-care scores of ACT and reality therapy groups compared to control group among type II diabetes patients (P <. 05, F = 56.55). The effectiveness of ACT and reality therapy interventions on self-care rates in type II diabetes patients is different. The mean of self-care variable after intervention in the ACT group increased compared to reality therapy. Due to the significant effect of ACT treatment on self-care behaviors of patients with type II diabetes, it is recommended that this therapy can be used in diabetes treatment centers to promote self-care and thus improve the control of diabetes in patients.

CORRELATION BETWEEN FAMILY SUPPORT AND SELF-CARE BEHAVIOR OF HEART FAILURE PATIENTS

The decrease in the functional capacity of the heart to pump blood accompanied by symptoms of dyspnea causes heart failure patients to have physical limitations. This condition causes the patient to be unable to carry out self-care optimally, thus requiring the help of others, especially family. The study aimed was to identify the relationship between family support and behavior self-care of heart failure patients. The research design used a cross-sectional with many samples as many as 104 respondents. The research variable is family support, and self-care behavior measured using a questionnaire was declared valid and reliable. Data analysis used the Spearman rank test. The results study 53,8% of respondents moderate family support, and 47,1% of respondents have fewer self-care behavior skills. The Spearman Rank test results obtained p=0,000, with a correlation coefficient value of 0,709. The study concluded a relationship between family support and the self-care behavior of patients with heart failure, the relationship positively and strong. Better family support provides better self-care behavior will be. Nurses have a role to motivate families to be actively involved during the patient's self-care process while in the hospital or at home. Self-care for patients that can be carried out by the family in the form of caring for the family with the patient's condition, accepting the family with the patient's condition, providing assistance and seeking information about the patient's illness.

Self-Care Behaviors in Patients with Hypertension to Prevent Hypertensive Emergencies: a Qualitative Study Based on the Theory of Planned Behavior

Abstract Background: Hypertension is a crucial general health issue. Severe and acute hypertension needs urgent medical intervention. Self-care behaviors can help patients with hypertension in controlling blood pressure and preventing hypertensive emergencies. This study aimed to determine the perception of hypertension towards self-care behaviors using constructs of the theory of planned behavior (TPB) in critically ill patients with hypertension to prevent hypertensive emergencies. Material and Methods: This study was conducted based on the directed qualitative content analysis of 33 critically ill patients with hypertension who participated in semi-structured interviews and focus group discussions. Results: The data were analyzed based on the four main categories of TPB. The attitude category consisted of positive and negative subcategories. The subjective norms category consisted of authority of healthcare staff, family support and approval, and influence of friends subcategories. The perceived behavioral control category included discipline, self-control, receiving consultation, individual concerns, financial problems, access to medicine, food culture, and coronavirus limitations subcategories. The behavioral intention category had intention to perform the behavior and intention to continue a behavior subcategories. Conclusion: The results revealed the requirement for a multidimensional approach to improve attitude, subjective norms, and behavioral control for performing self-care behaviors to reduce the number of hypertensive emergencies in critically ill patients with hypertension. Factors affecting self-care included socioeconomic status, family support, governmental organizations, and participants’ health condition.

The Role of Family Support on Self-Care Behavior in Patients Diabetes Mellitus (DM) Type 2

Diabetes Mellitus (DM) is a chronic disease as a metabolic disorder described by an increase in glucose levels above the average. 80% of the prevalence of DM, most of them are type 2 DM. Self-care is one of the important things that people with DM must do to prevent complications. The purpose of this study is to determine the role of family support on self-care behavior in patients with Type 2 DM. The method used is a full text critical review in English on the PubMed, Scopus, Web of science and Google Scholar databases with research subjects with type 2 DM. There are 7 articles that meet the inclusion criteria related to the topic. Analysis of 7 articles showed that family support could improve self-care behavior of patients with type 2 diabetes. Having family support will make type 2 DM sufferers have a higher level of adherence in controlling blood sugar.

Foot Care Performance and Foot Self-Care Behaviors in Iranian Patients with Type 2 Diabetes: A Cross-Sectional Study

Objective: A diabetic foot ulcer is one of the preventable complications of diabetes that can lead to amputation, morbidity, and mortality and increase treatment costs. This study aimed to investigate the relationship between self-care behaviors, demographic-clinical variables and, foot care performance in patients with diabetes. Materials and methods: This descriptive-analytical study was performed on 191 patients with type 2 diabetes in Asadabad (Hamadan province) in 2021. The demographic-clinical information form, the diabetic foot care performance scale, and the diabetic foot self-care behavior scale were used to collect data. The data were analyzed using descriptive and inferential statistics (multiple linear regression). Data analysis was performed using R software version 4.1.0. Results: The mean age of the subjects was 50.58 ± 11.87 years, and the duration of diabetes was 8.55 ± 9.07 years. There was a significant relationship between foot self-care behavior and age (p = 0.027), primary and secondary education compared to university education (p=0.042), insulin use compared to use of oral agents and insulin (p = 0.014), the logarithm of the duration of diabetes (p = 0.0001), foot care performance (p = 0.010). Conclusions: The status of self-care behaviors in patients with diabetes is unfavorable, and it is necessary to provide the necessary training to these patients to improve self-care and foot care.

Relationship between Self-Care Behavior and Diabetes Self-Management Education in Patients with Diabetes Mellitus Type 2

Diabetes mellitus type 2 is a disease caused by disruption of insulin secretion and insulin resistance. One aspect that plays an important role in the management of this disease is diabetes self-management education. Good self-care behavior will make diabetes management controlled and prevent complications and make the quality of life better. The purpose of this study is to determine the effect of self-care behavior and the magnitude of the influence of knowledge, patient motivation, family support, and self-efficacy on diabetes self-management education for type 2 diabetes mellitus patients. The method used in this study was a quantitative approach using cross-sectional methods. The sample used was 115 patients with type 2 diabetes mellitus in Palopo Regency. The analytical method used is the Structural Equation Model (SEM) using Amos 2.0 and SPSS 20 (IBM Corp). The findings of the study showed that self-care behavior in patients with diabetes mellitus of type 2 was influenced by knowledge factors by 89%, motivation factors by 82.8%, family support by 84.9%, and self-efficacy factors by 78.4%. Meanwhile, diabetes management of type 2 diabetes mellitus patients was influenced by treatment factors by 75.5%, blood sugar control factors by 88.1%, dietary factors by 60.9%, physical activity factors by 87.3%, and foot care factors 53. , 8%. The structural model of this study explains the variable care cell behavior with self-care management of 47.5%. Therefore, the management of diabetes mellitus must be more active in providing education to sufferers so that their knowledge or family members can increase and understand how to carry out diabetic management properly.

The Effect of the Continuous Care on the Self-Care Behavior in Hematopoietic Stem Cell Transplantation (HSCT) Recipients: A Semi-Experimental Study.

Background: Hematopoietic stem cell transplantation strongly affects the care of patients suffering from malignant hematologic disorders and the implementation of interventions such as continuous care can affect the outcomes of treatment in a positive way. The aim of the current study was to determine the effect of implementing a continuous care model on self-care behavior in patients receiving HSCT between 2019 and 2020 in Shariati Hospital affiliated to Tehran University of Medical Sciences. Materials and Methods: This semi-experimental study was conducted on 48 patients who were considered as candidates for HSCT at the Hematology, Oncology and Stem Cell Transplant Research Center, Shariati Hospital. Participants for the present study were selected by the continuous care model based on the inclusion criteria. A 4-stage continuous care model (CCM) developed was used as an intervention in the study. A valid and reliable assessment questionnaire designed to measure the self-care behaviors of the patient (PHLP2) was used for the collection of demographic information. It was completed in the first and fourth stages of implementing the continuous care model. Data were analyzed using SPSS 22 software (Chicago, IL, USA). Moreover, the Chi-square test, pair t-test, and independent samples t-test were used in this study. Results: There was no statistically significant difference between the intervention and control group in terms of demographic variables (p>0.05). Prior to intervention, no statistically significant difference was observed in the mean self-care score among HSCT patients in the intervention and control group (p=0.590), while, after the intervention, a statistically significant difference was observed in the mean self-care score among HSCT patients in the intervention and control group (p<0.001). Conclusion: The study concluded that due to the increase in the number of patients undergoing HSCT across the country in recent years as well as the ease of implementation and low cost of this strategy to promote the self-care of HSCT recipients, relevant authorities ought to do it with the proper planning and policy nationwide. According to the results of the study, the use of a continuous care model on self-care behavior in patients receiving HSCT is recommended.

Factors associated with self-care behavior in patients with pre-dialysis or dialysis-dependent chronic kidney disease.

Self-care behavior plays a pivotal role in the management of chronic kidney disease. Improved self-care behavior in patients with chronic kidney disease is a key factor in health management and treatment adherence. This study aimed to evaluate the participants’ general and medical condition-related characteristics, physiological indices and the level of health literacy affecting self-care behavior in patients with chronic kidney disease in South Korea. The data of 278 participants were analyzed using t-test, analysis of variance, correlation coefficient, and linear multiple regression analysis. There were significant differences in self-care behavior scores depending on participants’ age and cohabitation status, employment, and smoking status as well as having dialysis due to end-stage kidney disease; number of comorbidities; levels of serum hemoglobin, calcium, and creatinine; and estimated glomerular filtration rate. The results of regression analysis revealed that not currently working, non-smoker, end-stage kidney disease, and positive response to the “actively managing my health” scale of the Health Literacy Questionnaire significantly affected self-care behavior in patients with chronic kidney disease, and the explanatory power of the model was 32.7%. Therefore, it is necessary to identify each patient’s barriers or needs according to individual characteristics, such as age, cohabitation and employment status, and daily life circumstances, including smoking habits, comorbidities, social support, and level of health literacy to develop efficient support strategies for promoting adequate self-care behavior with CKD.

Correlation Between Affective Status and Self-care Behaviors in Patients with Heart Failure

Background: Poor self-care in patients with Heart Failure (HF) is directly associated with the patient’s general health getting deteriorated and hospitalized. Objectives: One of the factors influencing compliance with self-care behaviors is mood status. The aim of this study was to determine the relationship between affective status with self-care behaviors in patients with HF. Materials &amp; Methods: In this analytical cross-sectional study, 372 HF outpatients referring to a specialized heart clinic have been included using convenient sampling method. Study tools had 4 parts including demographic and social factors, the European Heart Failure Self-care Behaviors scale, and positive and negative affect scales. The collected data were analyzed using multivariate linear regression model. Results: The multivariate model adjusted for patient’s education, suffering from chronic obstructive pulmonary disease, and heart failure duration showed that positive affects (β=0.113, Standard Error (SE) =0.056, P=0.046) and negative affect (β=0.341, SE=0.053, P&lt;0.001) were significantly related to self-care behaviors, but anhedonia did not have any significant relation with self-care behaviors (β= -0.105, SE=0.097, P=0.280). The separate models accounted for 8 to 11% of the variance in the self-care behaviors. Conclusion: The result of current study indicates that patients’ mood statue including positive and negative affect are significant contributors of self-care behaviors. So, it is recommended that in addition to the patient’s physical condition, the rehabilitation program of the heart failure patients should incorporate their psychological and mental status

The Effect of Peer Group-Based Training Using Health Belief Model on Quality of Life and Foot Ulcer Self-Care Behaviour in Patients with Type 2 Diabetes: A Randomized Controlled Clinical Trial

Objective: The present study was aimed at investigating the effect of peer group-based training (PGBT) using the health belief model (HBM) on the quality of life (QOL) and foot ulcer self-care behavior in patients with type 2 diabetes. Materials and methods: The present study was a randomized controlled clinical trial performed on patients with type 2 diabetes who were referred to the Diabetic Care Clinic in Shiraz (Iran) from September 2019 to June 2020. A total of 70 patients participated in the study and were randomly assigned to peer training (n = 35) and control groups (n = 35). Diabetes Quality of Life, and diabetes self‑care behaviors, which were completed by both groups before, immediately, 1 month, and 3 months after the intervention. The data were analyzed using the Chi‑square test, paired t-test, independent t‑test, ANOVA, and descriptive statistical methods. P &lt; 0.05 was considered statistically significant. Results: The results showed that mean scores of QOL, constructs of HBM (awareness, perceived susceptibility, perceives severity, perceived benefit, self-care behavior, and foot care) before the intervention did not reveal a significant difference between the two groups, but immediately one month after the educational intervention, the mean values for the intervention group were significantly higher than the control group (p &lt; 0.05). Conclusions: PGBT using HBM was effective in increasing the mean score of QOL and self-care behavior in patients with type 2 diabetes. Thus, this method is recommended to be utilized alongside other methods to train patients.

Psychosocial Adjustment and Self-Care Behaviors of Heart Failure Patients

Psychosocial Adjustment and Self-Care Behaviors of Heart Failure Patients

Factors influencing self-care behaviours of patients with type 2 diabetes in China based on the health belief model: a cross-sectional study

ObjectivesThe study aimed to explore the status and predictors of self-care behaviours in patients with type 2 diabetes in China based on the health belief model.DesignThe cross-sectional study included 1140...

FACTORS ASSOCIATED WITH ADHERENCE TO MEDICATIONS, DIET AND SELF-MONITORING IN PATIENTS WITH HEART FAILURE

Objectives: Adherence to treatment and lifestyle changes is necessary for patients with heart failure. The objective of this study was to determine the factors associated with adherence to medications, diet, and self-monitoring of patients with heart failure. Methodology: This research was conducted as a descriptive cross-sectional study. The data were collected using the patient information form and beliefs and compliance scales for patients with chronic heart failure. Results: The average age of patients was 68.75±12.54. While the medication adherence barrier scores of the patients were slightly higher (21.53±0.32), the diet adherence benefit scores of the patients were slightly higher (20.67±0.40), and self-monitoring adherence barrier scores of the patients were higher (34.55±0.29). Conclusion: Identifying barriers or benefits of medication and dietary adherence may improve self-care behaviours in patients with HF. In clinics, it may be useful to provide training about potential barriers perceived by patients.

Self-care behaviors of patients with implanted left-ventricular assist device in Israel: a comparative study before and during COVID-19 pandemic

Funding AcknowledgementsType of funding sources: None.Background/IntroductionLeft ventricular assist devices (LVADs) support the heart of patients with advanced heart failure. Following LVAD implantation, patients face a complex regimen of self-care behaviors including self-care maintenance, self-care monitoring and self-care management. During the COVID-19 pandemic, the self-care might be inadequate because of the disease occurrence as well as social constraints, transportation restrictions, social distancing, and psychosocial stress. Little is known on how comparable specific self-care behaviors are among LVAD-implanted patients before and during COVID-19 pandemic.PurposeTo describe and compare self-care behaviors among patients with an implanted LVAD in Israel before and during the COVID-19 pandemic and explore factors related to self-care behaviors change.MethodsA prospective observational cross-sectional study design. A convenience sample of 28 Israeli LVAD-implanted patients (mean age 62.4 ± 9, 86% male, 78.6% lived with a partner) completed an LVAD Self-Care Behavior Scale before (data collection: March, 2017- February, 2020) and again, following the onset of COVID-19 pandemic in Israel in March 2020 (data collection: April, 2020 – September, 2020). The patients responded to 33 statements about how they perform self-care behaviors on a 5-point Likert scale ranging from 1 (never) to 5 (always). Statistical analyses included paired t-test and one-way repeated measures ANOVA.ResultsAttending scheduled clinic visits (M=4.93) and keeping the exit site and the driveline clean and dry (4.89) were two highly prevalent behaviors that did not change during the COVID-19 pandemic. The significant decrease in adherence during the COVID-19 pandemic was found in checking and recording LVAD speed, flow, power and PI (Mbefore=3.88±1.48 vs Mduring=3.08±1.55, t=2.02, p=.05), checking INR (Mb=5.0±0 vs Md=4.78±.42, t=2.73, p=.01), and weighing daily (Mb=4.54±.71 vs Md=3.92±1.06, t=3.19, p<.01). Adherence to the following behaviors increased most prominently, but not statistically significantly: talking to an LVAD team when feeling sad or worried (Mb=3.13±1.65 vs Md=3.71±1.55, t=1.39, p=.18) and contacting the LVAD team in case of symptoms (Mb=4.52±.96 vs Md=4.80±.5, t=1.37, p=.18).Compared to patients with a partner, those without a partner tended to worsen their adherence to some of the self-care behaviors e.g. taking medicines as prescribed (Mb=5.00±0 and Md=5.0±0 vs Mb=5.0±0 and Md=4.6±.89, F=4.85, p=.04, respectively).ConclusionsPriorities in self-care behaviors among patients with implanted LVAD may differ before and during a pandemic. In several crucial behaviors in self-care maintenance and management (checking and recording LVAD and INR, and taking medicines) and self-care monitoring (daily weighing) the adherence decreased significantly. The current results may guide further research on identifying behaviors at risk of not being maintained in a time of emergency.

Depressive symptoms are mediating the relationship between non-cardiac comorbidities and self-care of heart failure

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): Improving Self-Care Behavior and Outcomes in Rural Patients with Heart Failure; National Research Foundation of Korea grant funded by the Korea government (MEST) Background Most patients with heart failure (HF) have multiple chronic comorbid conditions. For HF patients with non-cardiac conditions, adhering to recommended self-care regimens can be complicated because recommended regimens across those conditions can even conflict with each other. Our previous study has shown that the significant relationship between non-cardiac comorbidities and HF self-care disappeared after covariates were entered in the regression model. The lack of the direct effect of non-cardiac comorbidity on HF self-care may be due to the effects of a possible mediator. Depressive symptoms are highly prevalent to patients with heart failure and in those with multiple chronic conditions, and negatively affect patients’ adherence to self-care. Therefore, it is possible that depressive symptoms mediate the relationship between non-cardiac comorbidities and self-care. Purpose To examine the mediating effect of depressive symptoms on the relationship between non-cardiac comorbidities and HF self-care in patients with HF. Methods A total of 590 patients with HF (66 years, 41% female, 35% New York Heart Association function class III/IV) were included in this study. The list of non-cardiac conditions was identified from the Charlson Comorbidity Index. Depressive symptoms were measured with the 9-item Patient Health Questionnaire (PHQ-9). Self-care was measured with the 9-item European HF self-care behavior scale (EHFScBS). The EHFScBS scores were standardized ranging from 0-100, with higher scores indicating better self-care. The mediation analysis was conducted using the PROCESS macro program in SPSS (version 3.5) with 5000 bootstrap samples. Results Less than one-third of the patients (30.8%) had clinically significant depressive symptoms (PHQ-9 scores of 10 or greater). On average, patients had one non-cardiac comorbidity. The results of the mediation analysis were presented in the Figure. The total effect of the number of non-cardiac comorbidities on HF self-care was significant, after adjusting for covariates. The direct effect of the number of non-cardiac comorbidities on HF self-care was not significant, while the indirect effect mediated by depressive symptoms was significant. This indicate the mediation of depressive symptoms on the relationship between the number of non-cardiac comorbidities and HF self-care. Conclusion We found that the depressive symptoms are a mechanism linking non-cardiac comorbidities and HF self-care. This result indicates that depressive symptoms is a greater barrier to engaging in HF self-care than the complexity of managing non-cardiac comorbidities. Therefore, clinicians need to assess and manage depressive symptoms to improve HF self-care for HF patients with non-cardiac comorbidities.

Factors Influencing Self-Care Behaviors in Hypertension Patients With Complications.

PurposeWhile hypertension with accompanying complications remains a life-threatening illness, a critical program in its management and prevention is implementing self-care behaviors (SCBs). This study examined the factors associated with SCB that are dominant in hypertension patients with complications.Materials and MethodsThis quantitative study was conducted using the regression analytic method and a cross-sectional approach. The non-probability sampling technique was used, and the response rate was 96.2%. Data were collected using a modified hypertension self-care profile (HBP-SCP) questionnaire, hypertension knowledge questionnaire, family support questionnaire, and the brief-illness perception questionnaire (B-IPQ).ResultsThe mean total SCB score was high at 55.9% with a mean of 191.01, SD = 5.16; 77.5% of the respondents had no disease history, 80.4% had good knowledge, 58.8% had strong family support, and 50% had a good perception of the disease. Factors that were significantly related to SCB were family support (p = 0.00, r = 0.75) and illness perception (p = 0.00, r = 0.77), while disease history (r = 0.47) and knowledge were not significantly related (r = 0.13). Moreover, the analysis of multiple linear regression with the backward method showed that the most dominant factor influencing SCB was illness perception (p = 0.00, = 0.47, B = 0.495, R2 = 0.650). The effect of illness perception on SCB (65%) meant that each 0.50 perception score increased the SCB score by one.ConclusionIt is recommended that health workers increase patient perception using innovative interventions to improve the SCB of hypertension patients with complications.