Self-care Behaviour Scale Research Articles

Development of an Instrument for Measuring Self-Care Behaviors After Left Ventricular Assist Device Implantation.

Successful long-term left ventricular assist device (LVAD) therapy necessitates a high degree of self-care. We aimed to develop an instrument that measures self-care behaviors in adult patients living with an LVAD. We used the method to develop patient-reported outcomes recommended by the US Food and Drug Administration. Prior to developing the instrument, a literature review was conducted to generate items using the middle-range theory of self-care of chronic illness as a guiding framework. A 2-round Delphi method, involving 17 clinicians with expertise in heart failure and assist devices from the Netherlands, Israel, United States, Canada, and Japan, was used to generate and select items. In the first Delphi survey, the levels of importance, relevance, and clarity of items in the instrument were evaluated. The second Delphi survey was performed to gain consensus on the final selection of items. We also examined face validity. A preliminary 37-item version of the Self-Care Behavior Scale was produced. The first panel judged 33 items as important and relevant, taking out 4 items due to vague wording and duplication and adding in 4 items. In the final 33-item version, 19 items address self-care maintenance behaviors, 10 items address self-care monitoring behaviors, and 4 items address self-care management behaviors. Patients (N = 25) did not have any difficulties understanding items and report any missing items. The 33-item Self-Care Behavior Scale for patients with heart failure having an LVAD has been developed and is ready for further psychometric testing.

Relationship between self-care behaviors and quality of life in patients with heart failure

BackgroundIt has been generally agreed that cardiac failure is one of the common and devastating diseases due to its morbidity, mortality and rates of disability. Moreover, it has negative impacts on quality of life among sufferers. Meanwhile, improving quality of life among heart failure patients is essential. It can be suggested that people with self-care ability have a better quality of life. However, this issue may be affected by some cultural issues. Regarding a paucity of information on this aspect in Iran, this study aims to explore the relationship between self-care behaviors and quality of life in patients with heart failure. MethodsThis study is carried out using a descriptive - analytical method. The sample size consists of 77 patients who consented to participate in the study and had ejection fraction <40%. The tools were demographic checklist, European heart failure self-care behavior scale, and SF-36 quality of life questionnaire. Data was gathered from the heart center of Imam Ali in Kermanshah-Iran. Data analysis was done using independent t-test, Mann Whitney, ANOVA, and Kruskal-Wallis tests by SPSS-24 software. FindingsThe study sample was 77 participants, of which 45 were female and 51 lived in an urban area. The mean of self-care score was 39.42 ± 7.04, and most of the patients (67.5%) were in moderate level. The mean and SD of quality of life was estimated as 38.45 ± 17.28. The spearman correlation test showed no correlation between self-care and quality of life. However there was a correlation between marital status and self-care ability, in which it shows the higher scores in unmarried people (K2 = 7.75, P = 0.021), and the results indicated better quality of life in male (t = 2.68, P = 0.009), educated patients at the level of university (F = 7.60, P < 0.001), free job (F = 6.21, P < 0.001) and lived in the urban area (Z = 2.05, P = 0.04). ConclusionIn this study, there is no correlation between self-care behaviors and quality of life in which, this may be attributed to Iranian cultures and perspectives such as valuing live with the children and importance of their attention to elderly patients, which demanded more studies.

Association Between User Engagement of a Mobile Health App for Gout and Improvements in Self-Care Behaviors: Randomized Controlled Trial.

BackgroundMobile health (mHealth) apps represent a promising approach for improving health outcomes in patients with chronic illness, but surprisingly few mHealth interventions have investigated the association between user engagement and health outcomes. We aimed to examine the efficacy of a recommended, commercially available gout self-management app for improving self-care behaviors and to assess self-reported user engagement of the app in a sample of adults with gout.ObjectiveOur objective was to examine differences in self-reported user engagement between a recommended gout app (treatment group) and a dietary app (active control group) over 2 weeks as well as to examine any differences in self-care behaviors and illness perceptions.MethodsSeventy-two adults with gout were recruited from the community and three primary and secondary clinics. Participants were randomized to use either Gout Central (n=36), a self-management app, or the Dietary Approaches to Stop Hypertension Diet Plan (n=36), an app based on a diet developed for hypertension, for 2 weeks. The user version of the Mobile Application Rating Scale (uMARS, scale: 1 to 5) was used after the 2 weeks to assess self-reported user engagement, which included an open-ended question. Participants also completed a self-report questionnaire on self-care behaviors (scale: 1-5 for medication adherence and diet and 0-7 for exercise) and illness perceptions (scale: 0-10) at baseline and after the 2-week trial. Independent samples t tests and analysis of covariance were used to examine differences between groups at baseline and postintervention.ResultsParticipants rated the gout app as more engaging (mean difference –0.58, 95% CI –0.96 to –0.21) and more informative (mean difference –0.34, 95% CI –0.67 to –0.01) than the dietary app at the 2-week follow-up. The gout app group also reported a higher awareness of the importance of gout (mean difference –0.64, 95% CI –1.27 to –0.003) and higher knowledge/understanding of gout (mean difference –0.70, 95% CI –1.30 to –0.09) than the diet app group at follow-up. There were no significant differences in self-care behaviors between the two groups postintervention. The gout app group also demonstrated stronger negative beliefs regarding the impact of gout (mean difference –2.43, 95% CI –3.68 to –1.18), stronger beliefs regarding the severity of symptoms (mean difference –1.97, 95% CI –3.12 to –0.82), and a stronger emotional response to gout (mean difference –2.38, 95% CI –3.85 to –0.90) at follow-up. Participant feedback highlighted the importance of tracking health-related information, customizing to the target group/individual, providing more interactive features, and simplifying information.ConclusionsParticipants found the commercially available gout app more engaging. However, these findings did not translate into differences in self-care behaviors. The gout app group also demonstrated stronger negative illness perceptions at the follow-up. Overall, these findings suggest that the development of gout apps would benefit from a user-centered approach with a focus on daily, long-term self-care behaviors as well as modifying illness beliefs.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12617001052325; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373217.

Effects of integrated nursing in heart failure patients with Vitacamphorae injection

Objective To explore the effects of integrated nursing in heart failure patients with Vitacamphorae injection. Methods From December 2016 to December 2017, we selected 160 heart failure patients with Vitacamphorae injection of Cardiovascular Department in Sino-Japanese Friendship Hospital of Jilin University as subjects by convenience sampling. All of the patients were divided into control group and experimental group with the random numbers, 80 cases in each group. Control group received routine nursing, while experimental group carried out integrated nursing. We compared the scores of European Heart Failure Self Care Behavior Scale (EHFSCB) and Minnesota Living with Heart Failure Questionnaire (MLHFQ) between two groups before and after intervention. Results After intervention, the scores of EHFSCB and MLHFQ of experimental group were lower than those of control group with statistical differences (P<0.05) . Conclusions Application of integrated nursing in heart failure patients with Vitacamphorae injection can improve their self-care ability and quality of life. Key words: Heart failure; Integrated nursing; Vitacamphorae injection; Adverse reaction

Most elderly patients hospitalized for heart failure lack the abilities needed to perform the tasks required for self-care: impact on outcomes.

To evaluate the abilities to perform essential tasks for heart failure (HF) self-management in elderly patients, and its influence on post-discharge prognosis. Overall, 415 patients ≥70 years old hospitalized for HF were included and followed during 1 year. The ability to perform six specific tasks (use of a scale, weight registration, diuretic identification, knowledge of salted foods, oedema identification, and treatment adjustment) was tested and distributed on terciles (T) of performance. Correlation with the self-administered questionnaire European HF Self-care Behaviour Scale (EHFScBS) was evaluated. The independent influence of self-care on 1-year mortality and readmission risks was calculated by Cox proportional hazards regression analysis. Mean age was 80.1years. On average, patients could perform 2.9±1.6 of self-care tasks, and only 5.3% could perform the six tasks correctly. Patients with previous HF self-care education had slight better performance (3.2±1.6 vs 2.8±1.6, P<0.02). A weak correlation was found between EHFScBS and number of tasks correctly performed (r=-0.135; P=0.006). One-year mortality in T1, T2, and T3 patients was 33.0%, 20.7%, and 14.1%, respectively (P=0.002). Multivariable analysis showed T2 and T3 groups having a lower adjusted mortality risk compared with T1 [hazard ratio (HR) 0.58; 95% confidence interval (CI) 0.32-1.03; and HR 0.40; 95% CI 0.21-0.77, respectively], without differences in readmissions. Most elderly patients admitted for HF are unable to perform several essential tasks needed for HF self-care. Self-perception of care was poorly correlated with real ability, and poor self-care ability was associated with higher 1-year mortality risk.

Development and psychometric properties of a self-care behaviors scale (SCBS) among patients with rheumatoid arthritis

BackgroundThe role of self-care behaviors in promoting physical function, pain management, health status and quality of life among patients with Rheumatoid Arthritis (RA) is well documented. However, there is no valid and reliable instrument in the literature to assess such behaviors among the patients. In the present study, we aimed to develop and assess the psychometric properties of a Self-care Behaviors Scale (SCBS) among patients with RA.MethodsIn 2017, applying a cross-sectional design, we recruited a convenient sample of 436 RA patients in Hamadan, Iran, to participate in the study. We developed the initial scale, including 30 items, after literature review, and having recommendations from an expert panel. Face, content, construct and convergent validity, as well as reliability of the scale were investigated.ResultsIn Exploratory Factor Analysis, the optimal solution comprising 25 items and 7 factors was emerged, which explained 62.5% of all variances between the items. In Confirmatory Factor Analysis, the measurement model fit the data well, and all subscales were significant within an acceptable range (χ2 [233] = 428.654, p < 0.0001, comparative fit index = 0.942, normed fit index =0.907, Tucker-Lewis index =0.916, and root mean square error of approximation = 0.043[(0.037–0.05]).ConclusionThe Self-care Behaviors Scale was found with appropriate validity, reliability, functionality and simplicity. To our knowledge, this scale is the only valid and reliable RA specific self-care behavior scale in the literature. Healthcare providers and health practitioners may apply the English version of this suitable instrument to find more valid and reliable data on RA self-care behaviors during primary assessments of the behaviors in educational interventions for the patients.

Self-Care Practices of Primary Health Care Patients Diagnosed with Chronic Heart Failure: A Cross-Sectional Survey.

Chronic heart failure patients require self-care behaviors and active monitoring of signs and symptoms to prevent worsening. Most patients with this condition are attended in primary healthcare centers. This study aimed to evaluate the endorsement of and adherence to self-care behaviors in primary health care patients with chronic heart failure. We conducted a multicenter cross-sectional study. We randomly included chronic heart failure patients from 10 primary healthcare centers in the Barcelona metropolitan area (Spain). Patients completed the European Heart Failure Self-Care Behaviour Scale, a health literacy questionnaire. Differences between groups were studied using ANOVA tests. We included 318 patients with a mean age of 77.9 years, mild limitations in functional activity New York Heart Association scale (NYHA) II = 51.25%), and a low health literacy index of 79.6%. The endorsement of self-care behaviors was low in daily weighing (10.66%), contacting clinicians if the body weight increased (22.57%), and doing physical exercise regularly (35.58%). Patients with lower educational levels and a worse health literacy had a lower endorsement. The screening of individual self-care practices in heart failure patients might improve the clinician follow-up. We suggest that primary healthcare clinicians should routinely screen self-care behaviors to identify patients requiring a closer follow-up and to design and adapt rehabilitation programs to improve self-care.

An educational intervention on foot self-care behaviour among diabetic retinopathy patients with visual disability and their primary caregivers.

To assess the effectiveness of a 12-week educational intervention on foot self-care behaviour among diabetic retinopathy patients with visual disability and their primary caregivers in China. Diabetes with the coexistence of diabetic retinopathy and foot problems complicating diabetes not only represents a personal disaster, but also becomes a serious burden to public health in China. A foot self-care educational intervention is both cost-effective and feasible even in a health resource-limited setting, which should be developed and evaluated. Quasi-experimental. From July-September 2017, we enrolled 80 eligible hospitalised diabetic retinopathy patients and their primary caregivers by convenient sampling method in a first-class comprehensive hospital in Nantong, in China. Before and after the educational intervention that is in accordance with the TREND statement (for details, see the "Supplementary File 1"), researchers and subjects filled out the self-designed questionnaire on foot problems complicating diabetes and the Diabetic Foot Self-care Behavior Scale, respectively. Scores of foot self-care behaviour among the subjects significantly improved from 54.19±8.01-75.85±5.04. The number of patients with fasting blood glucoses <7.0mmol/L improved from 43 (53.75%)-80 (100%). The results of incidence of foot problems complicating diabetes were not statistically significant. The complete execution of each item in Diabetic Foot Self-care Behavior Scale of subjects was apparently higher. This educational intervention can facilitate positive foot self-care behaviours among the diabetic retinopathy patients with visual disability and their primary caregivers in China. This study adds to the evidence of the effectiveness of an educational intervention to foster positive foot self-care behaviours. This educational intervention appears to be prospective in promoting diabetic home-based self-management in China, and the delivery method of the intervention may be applied to other chronic diseases.

Psychometric Evaluation of the Persian eHealth Literacy Scale (eHEALS) Among Elder Iranians With Heart Failure.

The purpose of the present study was to examine the psychometric properties of the eHealth Literacy Scale (eHEALS) using classical test theory and modern test theory among elderly Iranian individuals with heart failure (HF). Individuals with objectively verified HF (n = 388, 234 males, mean age = 68.9 ± 3.4) completed the (i) eHEALS, (ii) Hospital Anxiety and Depression Scale, (iii) Short Form 12, (iv) 9-item European Heart Failure Self-Care Behavior Scale, and (v) 5-item Medication Adherence Report Scale. Two types of analyses were carried out to evaluate the factorial structure of the eHEALS: (i) confirmatory factor analysis (CFA) in classical test theory and (ii) Rasch analysis in modern test theory. A regression model was constructed to examine the associations between eHEALS and other instruments. CFA supported the one-factor structure of the eHEALS with significant factor loadings for all items. Rasch analysis also supported the unidimensionality of the eHEALS with item fit statistics ranging between 0.5 and 1.5. The eHEALS was significantly associated with all the external criteria. The eHEALS is suitable for health-care providers to assess eHealth literacy for individuals with HF.

Self-care behavior and self-care agency in lowering salt consumption in hypertensive older patients based on orem's self-care theory

Introduction: Hypertension is a common chronic disease with multiple systemic complications. Reducing dietary salt intake is one of the most effective and economical methods for managing hypertension. The aim of this study was to investigate self-care agency and self-care behaviors of patients with hypertension in reducing dietary salt and its related factors in Tabriz. Methods: In a cross-sectional study, 250 hypertensive adults were selected in June 2016–2017 from a pool of referred patients to the general clinic at one large teaching hospitals in Iran. They were selected through purposive sampling method. The data collection tools included a demographic questionnaire, self-care agency scale, and self-care behaviors scale. Statistical analysis included simple and multiple (multivariable) linear regression. Results: For dietary sodium reduction, the mean scores (standard deviation) of self-care agency and self-care behaviors were 37.4 ± 10.04 and 36.5 ± 7.8, respectively. Variables with a significant correlation with self-care agency were marital status, age, and the years of hypertension diagnosis (P

Effectiveness of Health Education Program Regarding Foot Self-care on Risk for Developing Foot Ulcer Among Patients with Diabetes

Background: Diabetic foot has been considered as a major health problem in adults, because of its high incidence in recent years. Self-care programs have a role in the early prevention of morbidity and mortality rate of the diabetic foot, promoting patients knowledge and self-care practices are a crucial need in this regard. Aim of the study: To evaluate the effectiveness of health education program regarding foot self-care on risk for developing foot ulcer among patients with diabetes Research design: A quasi-experimental research design was used to conduct the current study. Setting: The current study was conducted in diabetes unit and outpatient clinics, at Benha university hospital, during the period from the beginning of September 2018 to beginning of June 2019. Subjects: A purposive sample of 132 patients recruited according to the study formula based on the total number of patients who admitted to the study settings during 2017, were randomly assigned into 68 patients in control group and 64 patients in intervention group, using permuted randomization table. Tools of data collection: Four tools were utilized for data collection, Tool I- Structured interviewing questionnaire sheet, involved (part 3) Structured Knowledge questionnaire, Tool II- Self-care confidence scale, Tool III- Foot self-care behavior scale and Tool IV- Inlow’s 60-second Diabetic Foot Screen. Results: Showed that mean score regarding knowledge, foot self-care confidence and behavior among intervention group were significantly higher after implementing intervention than among control group with a lower incidence of complications as well as there was a highly significant association between knowledge and self-efficacy among the studied groups, moreover the risk of developing foot ulcer was significantly lower among intervention group compared to control group post program implementation. Conclusion: The effectiveness of self-care educational program was approved in improving patients’ knowledge, self-care confidence, behavior and in return lowering the risk of developing foot ulcer. Recommendation: Based on findings in this study, regular continuing self-care programs should be designed to enhance patients’ ability to care for their foot with an emphasis on the most important risk factors and appropriate management in a large population.

Knowledge about heart failure and self-care persists following outpatient programme- a prospective cohort study from the Faroe Islands

ABSTRACT Objectives: Longer life expectancies imply increased prevalence of heart failure. Blittle is known about the maintenance of disease specific knowledge following patient education. Our aim was to investigate if self-care and heart failure knowledge persists at 9 month follow up among patients with heart failure after an outpatient programme in the Faroe Islands. Methods: A prospective cohort study with patients recently diagnosed with heart failure were recruited and evaluated by questionnaire at baseline, after 3 and 9 months using The European Heart Failure Self-Care Behaviour Scale and the Dutch Heart Failure Knowledge Scale. Clinical and demographic information was collected. Results: Seven (15%) women and 40 (85%) men with heart failure and NYHA > 2 were included. There was an overall improvement in patients’ self-care from baseline 25 (8) to 3 months 15 (5) and to 9 months (16 (45); both p < 0.001). Mean knowledge score 10 (3) improved to 13 (2) at 3 months and 12 (2) at 9 months (both p < 0.001). Conclusions: Disease specific patient education is applicable to heart failure patients, which can produce persistent improvements in self-care and knowledge after multidisciplinary outpatient programme. Practice Implications: Multidisciplinary outpatient programmes are beneficial for patients with heart failure and alters disease specific knowledge and self-care.

Gender differences in prognostic relevance of self-care behaviors on mortality and hospitalization in patients with heart failure – A report from the CHART-2 Study

BackgroundSelf-care behaviors (ScB) are associated with symptoms and outcomes in patients with heart failure (HF). However, little is known about gender differences in the prognostic relevance of ScB in HF patients. MethodsWe examined gender differences in ScB of HF patients regarding its prognostic associations with mortality and HF hospitalization with a reference to ScB dimensions. The European Heart Failure Self-Care Behavior Scale (EHFScBS) was used to evaluate ScB in 2233 patients with Stage C/D HF in the CHART-2 Study. ResultsMale patients (n=1583) were younger (71 vs. 73 yrs) and had lower ScB (median 33 vs. 31) (all p<0.001) than females (n=650). During the median follow-up of 2.57 years, patients with high ScB (score 12–32, n=1090), as compared with low ScB patients (score 33–60, n=1143), had significantly increased all-cause mortality in males [adjusted hazard ratio (aHR) 1.44, p=0.02] but not in females (aHR 0.80, p=0.40) (p for interaction 0.02), while ScB was not significantly associated with incidence of HF hospitalization in both genders. Among the 3 dimensions in EHFScBS, complying with regimen was associated with decreased mortality in females, but not in males (p for interaction 0.003), while asking for help was related with increased incidence of HF hospitalization in males (aHR 1.34, p=0.072) but not in females (aHR 0.98, p=0.931) (p for interaction 0.048). ConclusionsThere were gender differences in the prognostic relevance of self-care with mortality and incidence of HF hospitalization, suggesting that self-care should be implemented considering gender differences to improve prognosis.

Psychometric Validation of the Korean Version of the 9-Item European Heart Failure Self-Care Behaviour Scale.

Heart failure (HF) is the most common cause of frequent hospitalizations and high mortality. Active engagement in self-care behaviors is an essential component of HF disease management. Although the 9-item European Heart Failure Self-care Behaviour Scale (EHFScBS-9) as a commonly used instrument has been validated in different languages, there is no validated tool for addressing self-care behaviors related to HF in Korea. This study aimed to validate the Korean version of the EHFScBS-9. A cross-sectional study was adopted. The EHFSeBS-9 was translated and back-translated into Korean. A convenience sample of 270 patients from an outpatient clinic participated. Reliability was assessed via an internal consistency analysis. Construct validity was tested with exploratory factor and confirmatory factor analysis. Criterion validity was assessed by measuring participants' health literacy and general health status. Internal consistency was supported based on a Cronbach's α of .84. We identified three well-fitting factors (consulting behaviors, fluid restriction, and adherence behaviors), which explained 71.85% of the variance in self-care. More self-care behaviors were associated with adequate health literacy and good general health status. The Korean version of the EHFSeBS-9 showed sufficient internal consistency and acceptable validity to support its usage among Korean HF patients.

Relationship between self-care and social and clinical conditions of patients with heart failure

Objective: to identify the relationship between self-care measures and the social and clinical conditions of patients with heart failure. Methods: a cross-sectional study with 100 patients with heart failure, in outpatient follow-up. To assess self-care, the European Heart Failure Self-care Behavior Scale was used. Descriptive and inferential statistics were applied. Results: the self-care score presented an average of 35.17 ± 7.87, with a variation of 15 to 54 points. A lower average was found in the self-care score for female patients, with a significant difference (p <0.009). The recognition of the presence of lower limb edema, the daily monitoring of body weight and the regular practice of physical activity were presented as self-care measures with greater disagreement among the investigated participants. Conclusion: a better relationship was found between the self-care measures and the female sex.

Self-reported health and quality of life outcomes of heart failure patients in the aftermath of a national economic crisis: a cross-sectional study.

AimsThere are indications that economic crises can affect public health. The aim of this study was to describe characteristics, health status, and socio‐economic status of outpatient heart failure (HF) patients several years after a national economic crisis and to assess whether socio‐economic factors were associated with patient‐reported outcome measures (PROMs).Methods and resultsIn this cross‐sectional survey, PROMs were measured with seven validated instruments, as follows: self‐care (the 12‐item European Heart Failure Self‐Care Behaviour scale), HF‐related knowledge (Dutch Heart Failure Knowledge Scale), symptoms (Edmonton Symptom Assessment System), sense of security (Sense of Security in Care—‘Patients' evaluation’), health status (EQ‐5D visual analogue scale), health‐related quality of life (HRQoL) (Kansas City Cardiomyopathy Questionnaire), and anxiety and depression (Hospital Anxiety and Depression Scale). Additional data were collected on access and use of health care, household income, demographics, and clinical status.The patients' (n = 124, mean age 73 ± 14.9, 69% male) self‐care was low for exercising (53%) and weight monitoring (50%) but optimal for taking medication (100%). HF‐specific knowledge was high (correct answers 12 out of 15), but only 38% knew what to do when symptoms worsened suddenly. Patients' sense of security was high (>70% had a mean score of 5 or 6, scale 1–6). The most common symptom was tiredness (82%); 12% reported symptoms of anxiety, and 18% had symptoms of depression. Patients rated their overall health (EQ‐5D) on average at 65.5 (scale 0–100), and 33% had poor or very bad HRQoL. The monthly income per household was <€3900 for 84% of the patients. A total of 22% had difficulties making appointments with a general practitioner (GP), and 5% had no GP. On average, patients paid for six health care‐related items, and >90% paid for medications, primary care, and visits to hospital and private clinics out of their own pocket. The cost of health care had changed for 71% of the patients since the 2008 economic crisis, and increased out‐of‐pocket costs were most often explained by a greater need for health care services and medication expenses. There was no significant difference in PROMs related to changes in out‐of‐pocket expenses after the crisis, income, or whether patients lived alone or with others.ConclusionsThis Icelandic patient population reported similar health‐related outcomes as have been previously reported in international studies. This study indicates that even after a financial crisis, most of the patients have managed to prioritize and protect their health even though a large proportion of patients have a low income, use many health care resources, and have insufficient access to care. It is imperative that access and affordable health care services are secured for this vulnerable patient population.

Capability for self-care of patients with heart failure.

BackgroundA thorough analysis of the capability for self-care in patients with heart failure (HF) reduces the frequency of hospitalizations that are caused by decompensation. The aim of the study was to assess the effect of the method of therapy for HF, the degree of the acceptance of illness, and the occurrence of frailty syndrome on adherence to the therapeutic recommendations and self-care in patients with HF.MethodsThe study included 180 patients who were hospitalized after being diagnosed with HF. In all, we used the Polish versions of three validated instruments: the nine-item European Heart Failure Self-care Behavior Scale, Illness Acceptance Scale, and The Tilburg Frailty Indicator.ResultsThe capability for self-care of patients with HF was 27.8%. More than 65% of the patients followed the recommendations for taking medication and also followed a low-sodium diet, while only 5.5% of the patients followed the recommendations for physical exercise. Positive correlations were found between the capability for self-care and frailty syndrome and its components: general frailty components vs the capability for self-care: r=0.4449, P=0.0000; physical frailty components vs the capability for self-care: r=0.3974, P=0.0000; emotional frailty components vs the capability for self-care: r=0.2831, P=0.0001; social frailty components vs the capability for self-care: r=0.2180, P=0.0032, and a negative correlation between the capability for self-care and the degree of the acceptance of the illnesses (r=−0.4662, P=0.0000).ConclusionA relatively low capability for self-care was found in patients with HF. The presence of frailty syndrome and a low level of the acceptance of illness are connected with a low capability for self-care.

Changes in Heart Failure Self-care Behaviors and Intrathoracic Impedance over 6 Months.

Background Poor heart failure (HF) self-care has been shown by others to be associated with lung fluid accumulation measured by intrathoracic impedance. No studies, however, have examined how HF self-care is associated with intrathoracic impedance over time. Objective Examine the association of self-care behaviors and intrathoracic impedance using Medtronic Optivol Index threshold crossings as a marker of pulmonary congestion over 6 months. Method Patients with symptomatic HF and a Medtronic Optivol-enabled device had two 90 day periods of impedance data collected that corresponded with two waves of data collection on HF self-care (measured with the European HF Self-care Behavior Scale (EHFScBS)), as well as sociodemographic and clinical data. Changes in Optivol threshold crossings data (categorized as more frequent (31%) vs. fewer (69%) episodes of congestion) and self-care were calculated between the two phases of measurement. Multivariate logistic regression was use to quantify the likelihood of the self-care behaviors predicting an increase in threshold crossing over the 6 months. Results Participants (n=47) were mostly male (57%), on average 62 years old with predominantly non-ischemic (81%), NYHA Class III/IV HF (64%). Adjusting for sociodemographic and clinical factors, improvement in HF self-care care over time was associated significantly with lower odds of having more frequent threshold crossings over time (odds ratio=0.74; 95% confidence interval, 0.55–0.99; p=0.039). Conclusion Positive changes in HF self-care over time may decrease the odds of having more fluid accumulation or pulmonary congestion events. Our study supports self-care as an essential aspect of HF self-management. Furthermore, longitudinal and experimental studies are needed to examine the temporal and causal relationship between objective markers of HF pathophysiology and self-care behaviors.

Effects of a Tablet Computer on Self-care, Quality of Life, and Knowledge: A Randomized Clinical Trial.

Conflicting results have been reported for telemonitoring in patients with heart failure (HF). We wanted to evaluate whether patients using a tablet computer aimed at improving self-care behavior could do so and also whether it affects quality of life and health-related quality of life, disease knowledge, and in-hospital days. Patients with HF (n = 82) were randomized to the intervention group (IG) with a tablet computer (giving information and advice) or the control group (CG) that was subject to standard care. Study was completed by 72 patients, with a mean (SD) age of 75 (8) years, 68% male, and 74% NYHA class III. Self-care behavior measured with the 9-item European Heart Failure Self-Care Behaviour Scale, health related quality of life measured by the Kansas City Cardiomyopathy Questionnaire, quality of life measured by the Swedish version of the Health Survey, knowledge measured by the Dutch Heart Failure Knowledge Scale, days in hospital, and adherence were analyzed. The IG displayed better 9-item European Heart Failure Self-Care Behaviour Scale score (median IG, 16.5 [interquartile range {IQR}, 12-22], vs median CG, 23.5 [IQR, 18.8-30.0]; P < .05) and improved health related quality of life (median IG, 72.7 [IQR, 50.8-87.9], vs median CG, 51.8 [IQR, 40.9-62.8]; P < .05). A significant difference in knowledge was seen, with an 11% increase in IG and a 1% decrease in CG (P < .05), as well as a reduction in hospital days in IG by 2.7 days per patient (relative risk, 0.72; 95% confidence interval, 0.61-0.84; P < .05). The tablet computer significantly improved self-care behavior and health related quality of life, increased HF knowledge, and reduced hospital days.

Illness-related worries as a mediator among depression, anxiety and self-care in heart failure patients

PurposeThe purpose of this paper is to investigate the role of illness-related worries as a mediator among depression, anxiety and self-care in heart failure (HF) patients was the aim of this study.Design/methodology/approachThis study was descriptive and correlational study. In total, 149 patients with HF were selected for sampling in 2016. Patients completed self-care behavior scale, illness-related worries questionnaire and Depression Anxiety Stress Scale (DASS) questionnaires. The Pearson correlation coefficient and Sobel test were also done.FindingsAccording to the analysis of the Sobel test, the role of illness-related worries as a mediator in the relationship between depression and self-care result was −5.37. Sobel test analysis was done to assess the role of illness-related worries as mediator between anxiety and self-care (6.66). The correlation between depression and self-care was 0.488 (p<0.01); correlation between anxiety and self-care was 0.4 (p<0.01); correlation between anxiety and depression was 0.79 (p<0.01); and the correlation between illness-related worries and self-care was 0.71 (p<0.01).Originality/valueIllness-related worries can serve as a mediator in the relationship among depression, anxiety and self-care. There was a significant correlation among the research variables. Therefore, educational programs to reduce depression, anxiety and increase self-care should be given priority to for HF patients.