Self-Care Of Heart Failure Index Research Articles

Effectiveness and Cost-effectiveness of an Empowerment-Based Self-care Education Program on Health Outcomes Among Patients With Heart Failure

Strategies that enhance self-care of patients with heart failure reduce mortality and health care use. To examine whether an empowerment-based self-care education program was more effective and cost-effective to improve self-care, health status, and hospital service use than a didactic education program in patients with heart failure. In this double-blind randomized clinical trial, a consecutive sample of 988 patients with heart failure from the cardiac clinics of 2 regional hospitals underwent eligibility screening from February 1, 2017, to May 31, 2019, using the criteria of age of 55 years or older, heart failure diagnosed 6 months before screening, and New York Heart Association class II to IV. A total of 236 participants were randomized to the empowerment (n = 118) or education (n = 118) group. The 12-week, group-based, empowerment-based education program included self-care assessment, goal-orientated actions in symptom recognition and response, fluid and dietary modification, and lifestyle management. Didactic education covered the same topics without empowerment strategies. The primary outcome was self-care measured by the Self-care Heart Failure Index (SCHFI) maintenance, management, and symptom perception subscales at posttest and 3-month end points. Secondary outcomes included measures of knowledge, confidence, health-related quality of life, and health service use. Direct, indirect, and social costs of the 2 programs were collected for cost-effectiveness analysis. A total of 236 Chinese patients (mean [SD] age, 70 [8.0] years; 149 [63.1%] men) were included in the study. The empowerment group reported significantly greater improvement in SCHFI management scores (mean difference, 13.76; 95% CI, 5.89-21.62; Cohen d = 0.46 at posttest and Cohen d = 0.35 at 3 months) and symptom perception scores (mean difference, 20.36; 95% CI, 13.98-26.75; Cohen d = 0.84 at posttest and Cohen d = 0.61 at 3 months). The empowerment group had lower risks of emergency department attendance (incidence rate ratio, 0.55; 95% CI, 0.31-0.95; P = .03) and hospital admission (incidence rate ratio, 0.38; 95% CI, 0.21-0.68; P = .001) and better improved self-care knowledge (change in score [empowerment minus education], 1.29; 95% CI, 0.48-2.09) and confidence (change in score [empowerment minus education], 7.98; 95% CI, 1.91-14.05). Empowerment was cost-saving and cost-effective at T2 compared with the education group for quality-adjusted life-years, with an incremental cost-effectiveness ratio of -114 485. In this randomized clinical trial, an empowerment approach led to clinically relevant improvement in symptom perception and self-care management among patients with heart failure. Its cost-effectiveness in improving these prognostic factors also benefits the patient-reported outcome. Chinese Clinical Trial Registry: ChiCTR-IOR-16008254.

Self-care among persons with heart failure: Examining the impact of mindfulness and impulsivity using conditional process analysis.

According to the literature, self-care in persons with heart failure is inadequate. Such inadequate levels of self-care necessitate a thorough investigation of the potential predictors. To: (a) determine the level of self-care among persons with heart failure in Jordan; (b) determine the relationship between mindfulness, impulsivity, and self-care among persons with heart failure; (c) investigate the potential moderation effect of impulsivity on the relationship between mindfulness and self-care. A cross-sectional study was conducted. A convenience sample of 100 persons with heart failure in an outpatient clinic at King Abdullah University Hospital was recruited. The following tools were used to collect the data via phone survey: Self-Care of Heart Failure Index, Barratt Impulsiveness Scale, and the Mindful Attention Awareness Scale. The sample consisted of 78 male and 22 female persons with heart failure. The effect of mindfulness was statistically significant only on self-care symptom perception, and not significant on other aspects of self-care. Impulsivity moderated only the effect of mindfulness on self-care symptom perception. Correlation analysis showed a significant relationship between mindfulness and impulsivity (r = -.532, p < .01). Mindfulness is likely to improve at least one aspect of self-care (self-care symptom perception) and reduce impulsivity among heart failure persons.

Frailty Affects Self-Care Behavior in Congestive Heart Failure.

To explore the association between frailty and self-care in older adults with congestive heart failure and analyze their influencing factors. The cross-sectional study was conducted at the department of cardiology of a hospital in China from March 2018 to November 2018. A total of 165 participants were recruited. Frailty and self-care were measured by the Tilburg Frailty Indicator, and the Self-care of Heart Failure Index (V6). The physical, psychological, and social frailty exerted a significant negative association with self-care. Exercise, income, comorbidities, and times of congestive heart failure-related hospitalizations were independent risk factors for frailty; surgical treatment, comorbidities, and income were independent risk factors for self-care. These findings help to fill the need for new approaches to identify the high risk of frailty individuals in the acute care setting for targeted intervention and tailored transitions in care to promote optimal patient quality care and biopsychosocial well-being.

Fatores associados à contribuição dos cuidadores para o autocuidado na insuficiência cardíaca

Objective: to analyze the caregiver’s contribution to self-care in heart failure and the predictor variables of this contribution. Method: a cross-sectional descriptive and analytical study, with the participation of 140 dyads (patients and caregivers). The contribution to self-care was assessed using the Caregiver Contribution to Self-Care of Heart Failure Index. Caregivers and patients were interviewed separately to obtain the data. Multiple linear regressions were used to verify predictor variables of caregiver contribution. Results: the mean score for contribution to maintenance self-care was 62.7 (SD=7.1), for management, 62.9 (SD=20.4) and for confidence was 63.3 (SD=22.1). The variables number of patient’s medications, caregiver being related to the patient, social perception of caregiver, health-related quality of life of the patient and caregiver’s confidence in contributing to self-care were predictors of caregiver’s contribution to maintenance or management self-care. Conclusion: the caregiver’s contribution was insufficient. The social support perceived by the caregiver, the type of relationship the caregiver to the patient, the number of medications used by the patient, as well as the caregiver’s confidence in contributing to self-care are variables that should be considered to assess the risk of insufficient contribution of the caregiver.

Development and Validation of the Greek version of Self-Care Heart Failure Index (Gr-SCHFI) in Patients with Heart Failure

Background: Self-care of patients with heart failure (HF) is essential for the effective self-management of their disease, especially during the pandemic era. Self-care assessment instruments give the opportunity to Health Professionals to early recognize possible self-care needs and management of patients with HF. Aim: The translation and validation of the Greek version of the instrument “Self-Care of Heart Failure Index’’ (Gr-SCHFI), as well as the investigation of the psychometric properties of the instrument in a Greek-speaking population with HF. Methods: It’s a methodological study of an instrument validation. The psychometric properties of the Greek version of Gr-SCHFI were evaluated through reliability factors (Cronbach’s a and Composite Reliability), reliability of repeat test-retest and validity measures (content validity and concurrent validity). Brislin's (1970) methodology was used to translate the instrument to Greek language. Results: The study involved 176 patients, of whom 138 (78%) were men with an average of 69 years old. Most participants were in the NYHA III category [76 (57%)]. Confirmatory factor analysis showed very good measurements in the criteria: RMSEA = 0.07, CFI = 0.97, GFI = 0.98, AGFI = 0.98, NFI = 0.95, TLI = 0.97. The Cronbach's alpha index and the Composite reliability index had satisfactory internal coherence indicators (Cronbach's alpha 0.80-0.92, and Composite reliability 0.88-0.96, respectively). Conclusions: The Gr-SCHFI scale is a reliable and valid self-care assessment instrument for patients with HF. Self-care is necessary in HF where the evaluation and assessment of the self-care of the specific population is very important along the trajectory of the disease.

Factors associated with caregivers' contribution to self-care in heart failure.

to analyze the caregiver's contribution to self-care in heart failure and the predictor variables of this contribution. a cross-sectional descriptive and analytical study, with the participation of 140 dyads (patients and caregivers). The contribution to self-care was assessed using the Caregiver Contribution to Self-Care of Heart Failure Index. Caregivers and patients were interviewed separately to obtain the data. Multiple linear regressions were used to verify predictor variables of caregiver contribution. the mean score for contribution to maintenance self-care was 62.7 (SD=7.1), for management, 62.9 (SD=20.4) and for confidence was 63.3 (SD=22.1). The variables number of patient's medications, caregiver being related to the patient, social perception of caregiver, health-related quality of life of the patient and caregiver's confidence in contributing to self-care were predictors of caregiver's contribution to maintenance or management self-care. the caregiver's contribution was insufficient. The social support perceived by the caregiver, the type of relationship the caregiver to the patient, the number of medications used by the patient, as well as the caregiver's confidence in contributing to self-care are variables that should be considered to assess the risk of insufficient contribution of the caregiver.

The Effects of the ManageHF4Life Mobile App on Patients With Chronic Heart Failure: Randomized Controlled Trial.

BackgroundThe successful management of heart failure (HF) involves guideline-based medical therapy as well as self-management behavior. As a result, the management of HF is moving toward a proactive real-time technological model of assisting patients with monitoring and self-management.ObjectiveThe aim of this paper was to evaluate the efficacy of enhanced self-management via a mobile app intervention on health-related quality of life, self-management, and HF readmissions.MethodsA single-center randomized controlled trial was performed. Participants older than 45 years and admitted for acute decompensated HF or recently discharged in the past 4 weeks were included. The intervention group (“app group”) used a mobile app, and the intervention prompted daily self-monitoring and promoted self-management. The control group (“no-app group”) received usual care. The primary outcome was the change in Minnesota Living with Heart Failure Questionnaire (MLHFQ) score from baseline to 6 and 12 weeks. Secondary outcomes were the Self-Care Heart Failure Index (SCHFI) questionnaire score and recurrent HF admissions.ResultsA total of 83 participants were enrolled and completed all baseline assessments. Baseline characteristics were similar between the groups except for the prevalence of ischemic HF. The app group had a reduced MLHFQ at 6 weeks (mean 37.5, SD 3.5 vs mean 48.2, SD 3.7; P=.04) but not at 12 weeks (mean 44.2, SD 4 vs mean 45.9, SD 4; P=.78), compared to the no-app group. There was no effect of the app on the SCHFI at 6 or 12 weeks. The time to first HF readmission was not statistically different between the app group and the no-app group (app group 11/42, 26% vs no-app group 12/41, 29%; hazard ratio 0.89, 95% CI 0.39-2.02; P=.78) over 12 weeks.ConclusionsThe adaptive mobile app intervention, which focused on promoting self-monitoring and self-management, improved the MLHFQ at 6 weeks but did not sustain its effects at 12 weeks. No effect was seen on HF self-management measured by self-report. Further research is needed to enhance engagement in the app for a longer period and to determine if the app can reduce HF readmissions in a larger study.Trial RegistrationClinicalTrials.gov NCT03149510; https://clinicaltrials.gov/ct2/show/NCT03149510

Abstract 10934: Validity and Reliability of the Korean Version of the Revised Self-Care of Heart Failure Index V7.2

Background: The psychometric properties of the Korean version of the revised Self-care of Heart Failure Index (K-SCHFI v7.2) remain undetermined. Objectives: To examine validity (construct and predictive validity) and reliability of the 29-item K-SCHFI v7.2 in Korean patients with heart failure (HF). Methods: Using a cross-sectional, descriptive design, data on self-care and depressive symptoms were obtained for this psychometric testing. Construct validity was tested with confirmatory factor analysis (CFA) and predictive validity was tested through relationships between each self-care scale and depressive symptoms. Reliability was tested with Cronbach’s alpha and McDonald’s omega coefficients. Results: Patients with HF participated from four university-affiliated hospitals in South Korea (N = 207; mean age, 59.67 ± 13.87 years; male, 63.6%). CFA supported the construct validity of the K-SCHFI v7.2 (CFI from .931 to .977; RMSEA from .033 to .065), specifically, Self-Care Maintenance (CFI = .950, TLI = .931, SRMR = .063, RMSEA = .048); Symptom Perception (CFI = .931, TLI = .908, SRMR = .047, RMSEA = .065); and Self-Care Management (CFI = .977, TLI = .966, SRMR = .040, RMSEA = .033). Validity was further supportive with the relationships between the self-care and depressive symptoms, with patients with more depressed symptoms having poorer self-maintenance (t = 2.34, p = .018) and self-management (t = 2.00, p = .048). Reliability estimates were marginally satisfactory, with Cronbach's α and McDonald’s omega coefficients of .66 and .72 (Self-Care Maintenance), .78 and .82 (Symptom Perception), and .66 and .70 (Self-Care Management), respectively. Conclusion: Validity of the revised K-SCHFI v7.2 was supportive with a sound model fit and the relations to the depressive symptoms. Reliability of each scale was marginally supportive through the alpha and McDonald’s coefficients, while validation is required using a larger sample.

Abstract 9906: Not All Heart Failure Patients Are Men, Not All Caregivers Are Women: Comparing Differences by Gender

Background: Male patients with female caregivers are well represented in dyadic HF research. However, patient-caregiver dyads that are all male, all female, or female patients with male caregivers are not well described. Aim: Compare self-care, clinical, and psychosocial characteristics of patient-caregiver dyads based on the genders of dyad members. Methods: Secondary analysis of a cross-sectional study of patient-caregiver dyads (n=277) using the Caregiver Contribution to Self-Care of HF Index (CC-SCHFI) v2. Dyads were grouped by Patient-Caregiver gender: Male patient-Female caregiver, Female patient-Male caregiver, Female-Female, and Male-Male. Self-care was assessed using the Self-Care of Heart Failure Index and the matching CC-SCHFI. Standardized scores for both indexes range from 0-100 points; higher scores equal better self-care. Characteristics of dyad gender groups (comorbidities, HF duration, NYHA functional class, quality of life (QOL), age, marriage, habitation status, and length and type of caregiving relationship) were compared using chi-square, ANOVA and Kruskal-Wallis equality-of-populations rank tests. Results: Female caregivers of male patients were typically spouses (48%), whereas the majority of caregivers in other dyads were adult children/children-in-law (63-73%). Female patients cared for by female caregivers were older, not married and had worse physical QOL. Male and female caregivers of similar gender patients were younger (47.3±14.0 and 47.7±12.1), less likely to live with the patient and spent the fewest number of hours/day caregiving. Patients in these dyads were more likely to live alone and male patients had the lowest self-care monitoring (48.2±20.1 vs 59.2±18.3 for male patients with female caregivers, p =.06). Males caring for female patients had the lowest contribution to self-care maintenance (63.3±20.3, p =.04) and lower contributions to self-care monitoring, management, and self-efficacy. Conclusion: Patient-caregiver dyads of similar and mixed genders differ across a number of self-care, clinical, and psychosocial characteristics. Results suggest that dyad members’ genders may need to be considered in clinical and research practice.

Does an empowerment-based self-care supportive intervention save cost for improving self-care and health service utilization among heart failure patients

Abstract Background Heart failure (HF) evolves as a global pandemic and strains the over-stretched hospital service. Ineffective self-care remains the key factor to explain the avoidable hospital admission. Patient empowerment is as a theory-based strategy to optimize the patients' self-care changes for disease management [1]. Its cost-effectiveness to enhance self-care and health service utilization has yet to be determined. Purpose This was a double-blind randomized controlled trial to compare the effects and cost-effectiveness of a 12-week empowerment self-care program with a didactic education program on self-care maintenance and management as well as health service utilization among the community-dwelling HF patients. Methods A total of 236 HF patients were recruited from the specialist clinics of the Department of Cardiology in two regional hospitals. They were randomized to receive either the 12-week empowerment self-care program (Figure 1) or the 12-week didactic education. Outcome evaluation using the Self-care Heart Failure Index (SCHFI) at baseline, post-intervention (T1) and three months thereafter (T2), with record on the number of emergency room (ER) attendance and hospital admission. Cost effectiveness analyses were performed on total cost (medical, intervention and societal costs) incurred in both interventions as well as incremental cost-effectiveness ratios (ICER) expressed as incremental cost per 1) a reflected clinically meaningful improvement in self-care (i.e. a half standard deviation increase in SCHFI), 2) an ER attendance reduced, 3) a day of hospital stay reduced. Results As compared with the education group, the empowerment group reported significantly greater improvement in self-care management at T1 [B=13.77 (95% CI=6.07, 21.46), p&amp;lt;0.001] and T2 [B=10.98 (95% CI=3.21, 18.75), p=0.006]. For cost-effective analysis, The ICER (empowerment-education) was −USD220/0.5 SD increase in SCHFI, indicating the mean cost saved per patient for making a clinically significant improvement in self-care was USD 220. The cost-effectiveness acceptability curve showed patients were willing to pay at USD 207- 441 for a 80–90% chance of improved self-care, indicating that the empowerment approach was a cost saving strategy. Although the empowerment approach was associated with a lower risk of ER attendance [IRR=0.55, 95% CI=0.31–0.95)] and hospital admission [IRR=0.38 (95% CI=0.31–0.95)], it is not cost saving for reducing hospital service utilization. Conclusions The empowerment-based self-care program is a cost-saving strategy to produce a clinical significant change in HF-related self-care. Although it is associated with lower risk for hospital service utilization, its effect is not significant enough to be cost-saving. Future care model may explore the need to integrate dyadic science [2] and e-health [3] to strengthen the care continuity and effects of self-care intervention. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Health and Medical Research Fund, Food and Health Bureau, Hong Kong Special Administrative Region Figure 1

Psychometric evaluation of the nine-item heart failure self-care behavior scale (9-EHFScBS)

Background &amp; Aim: Self-care in patients with heart failure can improve multiple outcomes and reduce mortality. Measuring self-care requires valid and reliable tools. This study aimed to determine the psychometric properties of the 9-items European Heart Failure Self-Care Behavior Scale. Methods &amp; Materials: The present study is a psychometric evaluation. The original version of the tool was translated from English to Persian using the standard Backward-Forward method. The questionnaire's validity was assessed using face, content, criterion (the Self-Care of Heart Failure Index v.6 as a criterion), and construct validity. An exploratory factor analysis approach was used to construct validity with a sample of 216 patients with chronic heart failure referred to Dr. Shariati and Imam Khomeini Hospital's heart clinics in Tehran; and Ayatollah Mousavi Hospital in Zanjan. The reliability of the questionnaire was evaluated by internal consistency and stability methods. Results: After the validation process (validity and reliability), all 9 items of the questionnaire were approved and remained. The content validity index of the total content of the questionnaire was calculated to be 0.96. Based on factor analysis, only one factor was confirmed for the questionnaire. The correlation between the present questionnaire and the Self-Care of Heart Failure Index v.6 was positive and significant (p&lt;0.001, r=0.753). Internal consistency (α=0.728) and stability (0.897) of the questionnaire were also confirmed. Conclusion: The European Heart Failure Self-Care Behavior Scale is valid and reliable for measuring Iranian patients' self-care behaviors with heart failure.

Reliability Testing of Self-Care of Heart Failure Index v6.2 Chinese Instrument Among Heart Failure Patients

Objective: Self-Care of Heart Failure Index (SCHFI) v6.2 Chinese is an instrument used to assess the ability of self-care behaviour among heart failure patients. It has been validated in Taiwan, however, it is yet to be validated in Malaysia. As a multi-ethnic country, Chinese language has been one of the major languages in Malaysia. Therefore, this study was conducted to examine the reliability of Self-Care of Heart Failure Index (SCHFI) v6.2 Chinese among Malaysian population. Design: A successive independent sample design was used throughout a 4-months data collection period. Setting: Eighty heart failure patients from University of Malaya Medical Centre and National Heart Institute were recruited through purposive sampling. The two hospitals were chosen because they have specialized heart clinics that eased the data collection. The out-patients were screened by the cardiologists for their eligibility to participate in this study. Measures: The samples were administered with SCHFI v6.2 Chinese. The item endorsement index, internal consistency and item-total correlation of SCHFI v6.2 Chinese were examined. Results: The maintenance subscale of SCHFI showed a low internal consistency (Cronbach α = .52) while the management and confidence subscales showed an acceptable internal consistency (Cronbach α = .67 and .90 respectively). Conclusion: SCHFI v6.2 Chinese is a reliable instrument to be used among the Malaysian population.

SELF CARE ABILITY INFLUENCES THE QUALITY OF LIFE CONGESTIVE HEART FAILURE (CHF) PATIENTS

The prevalence of congestive heart failure sufferers in Indonesia is very high and is expected to continue to increase every year. Heart failure conditions and other manifestations cause a decrease in the quality of life due to the patient's inability to perform self-care properly. The purpose of this study was to determine the relationship between self-care ability and the quality of life of patients with congestive heart failure (CHF) in cardiac outpatient unit Arifin Achmad Hospital, Riau Province. This research was conducted on 64 respondents which by purposive sampling technique. Methode of this research was descriptive correlative with cross-sectional disign. The instrument of this research is the Self Care of Heart Failure Index (SCHFI) questionnaire to measure self-care ability and Minnesota Living with Heart Failure Questionnaire (MLHFQ) questionnaire to measure quality of life. The results of this study indicate that the respondent's self-care ability is balanced by good and bad as many as 32 respondents (50.0%) and the quality of life of the majority is bad as many as 39 respondents (60.9%). Based on the chi square test it can be concluded that p value= 0.01 (&lt;0.05) means that there is a significant relationship between self-care ability and the quality of life of people with congestive heart failure (CHF). The recommendation for further research is to study about the factors that influence self-care ability and quality of life in patients with congestive heart failure.

The Revised Self-Care of Heart Failure Index - a new tool for assessing the self-care of Polish patients with heart failure.

According to the European Society of Cardiology guidelines, self-care is a key part of treatment for patients with heart failure. A large evidence base has been accumulated regarding the direct impact of self-care on the outcome of patients with heart failure. In order to assess self-care in patients with heart failure and to evaluate the effectiveness of the interventions taken, a reliable and culturally acceptable instrument is required. The Revised Self-care of Heart Failure Index (SCHFI) is a new tool for assessing self-care in patients with heart failure. Our aim was to test the reliability of the Polish version of the Revised SCHFI. The standard forward-backward translation procedure was used to translate the Revised SCHFI questionnaire into Polish. The reliability of the SCHFI was assessed based on Cronbach's α, item-total correlation, exploratory factor analysis, and confirmatory factor analysis. A total of 127 patients with heart failure (mean [SD] age, 68.5 [11.2] years) completed the questionnaire. The mean (SD) total self-care score in the study group was 51.92 (22.0). Patients scored the highest in terms of self-care confidence (mean [SD] score, 65.63 [21.0] points), and the lowest in symptom perception (mean [SD] score, 54.64 [18.28] points). The Revised SCHFI had satisfactory psychometric properties in all subscales (self-care maintenance α = 0.790, symptom perception α = 0.790, self-care management α = 0.705). The Polish version of the Revised SCHFI is a reliable and valid instrument for assessing self-care level in heart failure patients.

Heart failure inpatient"s self-care behaviour: mulricenter approach focousing on gender differences

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Heart failure is often characterized by low exercise capacity and great impairment on performance in activities of daily living. The correct management of the disease can prevent the worsening of symptoms and promote a better quality of life. Self-care behaviour plays an important role on patient"s quality of life. Aim The aims of this study are to evaluate the self-care behaviour in a sample of heart failure inpatients, using the Self-Care Heart Failure Index (SCHFI) and to understand whether gender and patophisiologic characteristics does interfere on it. Methods Cross-sectional multicenter study enrolling 225 heart failure inpatients from eight hospitals. At admission, patient’s functional capacity was evaluated as well as their self-care behaviour, using the SCHFI Portuguese v6.2. Comparison between self-care behaviour with gender was performed. Also some correaltions were perfomed with the total sample of patients, aiming to understand which were the variables that may interfere with the socre of each sub-scale of the self-care HF index. Results Patients’ mean age was 68.4 ± 10.7 years old, 68% were male and 82.3% have reduced ejection fraction. A mean value of 47.9, 35.6 and 38.8 points was found in the SCHFI score of the sections self-care maintenance (SCMt), self-care management (SCMg) and self-care confidence (SCC), respectively. Heart failure inpatients present inadequate levels of self-care behaviour. No difference was found between genders on any section of the SCHFI. Among all variables, only the number of CVRFs and the left ventricular ejection fraction had significant differences. Males had better results, but not with a statistically significant difference. Association tests (ANOVA) between different variables and the score of each section of the SCHFI were perfomred. Only in the NYHA there are variables associated with a better self-care, namely in the SCMg (p = 0.011) and in SCC (p = 0.010). Correlations were made using the numeric variables age, CVRF, BI, LCADL, SCMt, SCMg and SCC, in order to understand the influence of the variables with each other. All the three dimesnions present a positive correlation, at 99% confidence interval between them (SCMt with SCMg: r = 0.365, p &amp;lt; 0.000; SCMt with SCC: r = 0.272, p &amp;lt; 0.000 and SCMg with SCC: r = 0.670, p &amp;lt; 0.000). In addition, SCMt presents a positive correlation with age at a 95% confidence interval (r = 0.158, p = 0.018). Negative correlations were found between 1) BI and age (r=-0.151, p = 0.023), at a 95% confidence interval and 2) BI with LCALD (r=-0.407, p &amp;lt; 0.000), at a 99% confidence interval. Regarding NYHA functional class and left ventricular systolic function, only NYHA class II patients present a statistically significant difference in SCMg and SCC comparing to Class III and IV patients (who do not present differences between them). Conclusion The results do not suggest a relationship between gender and pathophysiological characteristics with self-care behaviour.

Characteristics of Patients Who Do Not Respond to Motivational Interviewing for Heart Failure Self-care.

Motivational interviewing (MI) improves heart failure (HF) self-care for most yet fails to work for some patients. Identifying patients less likely to benefit from MI would save time in identifying a more suitable treatment for these patients. The aim of this study was to identify the characteristics of adults with HF less likely to clinically improve self-care after MI. This was a secondary intervention group analysis (n = 230) of MOTIVATional intErviewing to improve self-care in Heart Failure patients (MOTIVATE-HF), a trial evaluating MI in improving HF self-care maintenance and management. Self-care was measured with the Self-care of Heart Failure Index v. 6.2 at baseline and 3 months from enrollment. Participants were dichotomized into MI nonresponder (standardized score change <8 points) or MI responder (score change ≥8 points). Logistic regression, adjusted for group differences, identified determinants of nonresponse (odds ratio [95% confidence interval]). Significant risk factors for self-care maintenance nonresponse 3 months after the intervention were nonischemic HF (2.58 [1.33-5.00], P = .005) and taking fewer medications (0.83 [0.74-0.93], P = .001). These variables explained 29.6% of the variance in HF self-care maintenance. Risk factors for self-care management nonresponse were living alone (4.33 [1.25-14.95], P = .021) and higher baseline self-care management (1.06 [1.02-1.09], P < .001), explaining 35% of the variance in HF self-care management. Motivational interviewing may be less beneficial in patients with nonischemic HF and taking fewer medications. Patients with HF living alone with relatively better self-care management may be at risk for MI treatment failure. Identifying characteristics of nonresponders to MI in HF contributes to clinical decision making and personalized interventions.

A psychometric evaluation of the Caregiver Contribution to Self-Care of Heart Failure Index in a Thai population

BackgroundCaregivers are major contributor to the self-care of patients with heart failure. The Caregiver Contribution to Self-Care of Heart Failure Index (CC-SCHFI) measures these contributions across three scales: self-care maintenance (symptom monitoring and treatment adherence); self-care management (dealing with symptoms); and confidence in contributing to the self-care (self-efficacy in managing self-care) of patients with heart failure. Informal caregivers play a vital role in supporting family members with heart failure in Thailand, yet no validated tool exists to measure their contribution. We examined the psychometric properties of the CC-SCHFI in a Thai population.MethodsThe CC-SCHFI was translated into Thai using a standard forward and backward translation procedure. A cross-sectional design was used to examine the psychometric properties of the Thai version of the CC-SCHFI in 100 family caregivers of heart failure patients in Southern Thailand. Confirmatory factor analysis was used to assess construct validity, and factor score determinacy coefficients were computed to evaluate internal consistency reliability.ResultsThe Thai version of the CC-SCHFI demonstrated acceptable internal consistency (composite reliability of each scale ranged from 0.76 to 0.99). Reliability estimates were adequate for each scale (McDonald’s omega ranged from 0.75 to 0.96). Confirmatory factor analysis supported the original factor structure of the instrument, with good fit indices for all three scales (comparative fit index = 0.98–1.00; root-mean-square error of approximation = 0.00–0.07).ConclusionsThe Thai version of the CC-SCHFI appears to be a valid and reliable instrument for measuring caregiver contributions to self-care maintenance and self-care management as well as contributing to caregiver confidence in the self-care of Thai heart failure patients.

Self-management on heart failure: A meta-analysis

Background and aimsHeart failure (HF) is a severe public health problem all over the World. Self-management is an effective method to progress self-care ability. However, the role of self-management in heart failure has not been thoroughly elucidated. MethodsThe research articles related to heart failure were searched by the PubMed, Embase, Cochrane databases, and China National Knowledge Database on articles published through March 2020. The average 95% of confidence intervals (CIs) were used to calculate using random-effects or fixed-effects. Review Manager (version 5.2) was adopted for meta-analysis, sensitivity analysis, and bias analysis. ResultsEight (8) eligible studies with 1707 patients with HF were included in this analysis. In the Meta-analysis showed significant differences for Self-management (SM) groups in Dutch Heart Failure Knowledge Scale (DHFK) (MD = 1.36, 95%CI [-0.03, 2.75], P = 0.04; I2 = 83%), in Self-Care of Heart Failure Index (SCHFI) (MD = 5.51, 95%CI [0.62, 10.40], P = 0.03; I2 = 70%), and in Self-Efficacy for Managing Chronic Disease Scale (SEMCDI) (I2 = 47%, Z = 5.43, P of over effect < 0.0001) than control groups. One bias is detected as attrition bias, and another one is reporting bias. Sensitivity analysis satisfied the stability of the results. ConclusionSelf-management was associated with significant outcomes in patients with HF through knowledge, attitude, and practice (KAP).

Effects of Health Education Program and Improving Self-care among Vietnamese Adult Patients with Chronic Heart Failure in Nam Dinh Province Vietnam

This study aimed toimprove the knowledge and practice of self-care among Vietnamese adult patients with chronic heart failure in Nam Dinh province Vietnam. The one group pre-test and post-test educational intervention was conducted among 90patients with chronic heart failurein Nam Dinh General Hospital. The education programme based on the guidelines for self-care of heart failure by Vietnam National Heart Association 2015 and by American Heart Association2014. The evaluation knowledge and practice before and after based on the Atlanta Heart Failure Knowledge Testand the Self-care of Heart Failure Index. By the scale of 22 points for self-care knowledge, the mean score of participated patients before the intervention was 10.41 ± 3.54, then went up to 19.38 ± 2.16 points right after completing the intervention and retained at 17.92 ± 2.52 points at the time of one month later (p values of 0.001).By the scale of 100 points for each field of self-care practice,the mean scores of participated patientsbefore the intervention were limited in three fields of practicewith41.52 ± 20.51 points for self-care maintenance, 35.56 ± 15.21 points for self-care management, and 50.45 ± 16.11 for self-care self-confidence, thenpositive changes in comparison with these three fields before the interventionwere seen after completing the interventionone month,including 53.90 ± 20.03 points, 52.96 ± 15.08 points, and 59.31 ± 14.68, respectively(p values of 0.001).The study revealed a reality of limited self-care knowledge and practice among Vietnamese adult patients with chronic heart failure before the intervention and showed the initial positive results in improvingboth knowledge and practice of patients with chronic heart failure through the patient educationwhich helping themto do self-caring theirconditionand needs to be implemented regularly.

Race Moderates the Relationship Between Perceived Social Support and Self-care Confidence in Patients With Heart Failure.

African Americans are at the highest risk of developing heart failure (HF) compared with other races and are hospitalized at 7 to 8 times the rate of Whites. Poor overall self-care, low self-care confidence, and lower levels of perceived social support are factors related to increased risk for hospitalizations in HF. Yet, limited evidence is available regarding the factors that may differentially impact self-care confidence by race in patients with HF. The aim of this study was to examine to what extent race moderates the relationship between perceived social support and self-care confidence. This is a secondary analysis of cross-sectional data from African American and White patients with HF in North America (n = 429). Patients completed the Multidimensional Scale of Perceived Social Support and the Self-Care Confidence Scale of the Self-Care of Heart Failure Index. A moderation analysis was conducted using hierarchal linear regression. Sample mean age was 60.8 ± 11.5 years, 22.4% were African American, and 54.7% were in New York Heart Association class I or II. Moderation analyses yielded a significant interaction of perceived social support and race, showing White patients, not African Americans, have significantly different self-care confidence scores depending on level of social support: White, b = 0.224, 95% confidence interval [0.046-0.094], t = 5.65, and P < .001; African American, b = -0.776, 95% confidence interval [-0.049 to 0.060], t = 0.212, and P = .832. Our findings show a variable effect of perceived social support on self-care confidence as a function of race, suggesting the need for further research to develop and test interventions tailored to race and levels of social support in HF.