Article

Self-care behaviors among patients with heart failure

College of Nursing, Wayne State University, Detroit, Michigan, USA.
Heart and Lung The Journal of Acute and Critical Care (Impact Factor: 1.32). 05/2002; 31(3):161-72. DOI: 10.1067/mhl.2002.123672
Source: PubMed

ABSTRACT One way to prevent frequent hospitalizations and promote positive health outcomes among patients with heart failure (HF) is to ensure that the amount and quality of self-care used is appropriate to the patient's situation.
The following are the purposes of this study: (a) examine the frequency of performance of self-care behaviors, (b) describe personal and environmental factors (basic conditioning factors [BCFs]) that affect self-care behaviors, and (c) describe the relationship between the level of knowledge patients have to empower their performance of self-care and the actual performance of self-care behaviors.
This descriptive correlational study was guided by Orem's theory of self-care. One hundred ten participants, predominantly African Americans, who were outpatients or inpatients ready for hospital discharge, 18 years or older, and diagnosed with HF that was confirmed by an ejection fraction of 40% or less were conveniently selected from 1 of 2 sites. Data were collected with 2 investigator-developed instruments: the Revised Heart Failure Self-Care Behavior Scale and the Heart Failure Knowledge Test. Descriptive statistics, correlational analyses, and t tests for independent samples were used to analyze the data.
Three of the top 5 most frequently performed self-care behaviors were related to taking prescribed medications, and the 5 least frequently performed self-care behaviors were concerned with symptom monitoring or management. There were no significant relationships between the total self-care behavior score and any of the BCFs; however, a number of significant relationships between BCFs and individual self-care behaviors were observed. There was a significant relationship between the mean total knowledge score and the total mean self-care score (r = 0.21, P =.026).
Detailed information about the influence of BCFs on the performance of specific HF self-care behaviors can help nurses tailor interventions to the patient's situation.

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    • "The HFKQ contains 14 close-ended items and one open-ended, item, and content includes heart failure pathology, symptoms, medications, and self-management. Scores range from 0 (lack of knowledge) to 15 (knowledgeable) and the previously reported Cronbach's alpha of 0.62 [6]. In this study, Cronbach's alpha at baseline assessment (í µí±› = 81) was similar at 0.66. "
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    ABSTRACT: Background. Inadequate health literacy may be a barrier to gaining knowledge about heart failure (HF) self-care expectations, strengthening self-efficacy for self-care behaviors, and adhering to self-care behaviors over time. Objective. To examine if health literacy is associated with HF knowledge, self-efficacy, and self-care adherence longitudinally. Methods. Prior to education, newly referred patients at three HF clinics (N = 51, age: 64.7 ± 13.0 years) completed assessments of health literacy, HF knowledge, self-efficacy, and adherence to self-care at baseline, 2, and 4 months. Repeated measures analysis of variance with Bonferroni-adjusted alpha levels was used to test longitudinal outcomes. Results. Health literacy was associated with HF knowledge longitudinally (P < 0.001) but was not associated with self-efficacy self-care adherence. In posthoc analyses, participants with inadequate health literacy had less HF knowledge than participants with adequate (P < 0.001) but not marginal (P = 0.073) health literacy. Conclusions. Adequate health literacy was associated with greater HF knowledge but not self-efficacy or adherence to self-care expectations over time. If nurses understand patients' health literacy level, they may educate patients using methods that promote understanding of concepts. Since interventions that promote self-efficacy and adherence to self-care were not associated with health literacy level, new approaches must be examined.
    07/2013; 2013:353290. DOI:10.1155/2013/353290
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    • "Similar to self-management, self-care management is often used as a term that includes some parts of self-care in relation to the levels of glycaemia, such as Table 1 Personal factors that influence self-management. -Health status (Anderson et al. 1996, Artinian et al. 2002) -Duration of the disease (Tang et al. 2008) -Presence of comorbidity (Nam et al.2011) -Understanding the care plan (Nagelkerk et al. 2006) and the treatment regimen (Rubin 2005) -Complexity of treatment and medications (Rubin 2005, Khunti & Davies 2010) -Belief in treatment effectiveness (Xu et al. 2008) -Diabetes knowledge (Nagelkerk et al. 2006, Xu et al. 2008, Osborn et al. 2010, Zhong et al. 2011) -Self-care agency (Orem 1991, Sousa et al.2004, 2008, Sousa & Zauszniewski 2005) -Self-efficacy (Bandura 1977, Rubin et al. 1993, Corbett 1999, Glasgow et al. 2001, Bodenheimer et al. 2002b, Norris et al. 2002, Krichbaum et al. 2003, Deakin et al. 2005, Sousa et al. 2005, Whittemore et al. 2005, Peyrot & Rubin 2007, Funnell et al. 2008, Lanting et al. 2008, Xu et al. 2008, Zhong et al.2011, Qiu et al. 2012) -Age, educational levels, type of diabetes and duration of diabetes are significantly associated with diabetes knowledge, self-care agency and self-care activities (Sousa et al.2006) -Partner 's influence Martire et al. 2010) -Health literacy (Schillinger et al.2002, Krichbaum et al. 2003, Tang et al. 2008, Osborn et al. 2010), associated with advanced age, lower educational attainment and lower economic status (Paasche-Orlow et al. 2005) -Health beliefs, attitudes, health literacy, influenced in turn by culture and language capabilities (Nam et al. 2011) -Reflective process and decision-making (Rockwell & Riegel 2001). -Patients' adherence, attitudes, beliefs (Nam et al. 2011) -Family habits in Latin ethnic minorities (Weiler & Crist 2009) -Linguistic barriers, some ethnic minorities and lower educational levels (Karter et al.2000) -Social support (Xu et al.2008, Osborn et al.2010, Nam et al. 2011, Zhong et al. 2011) -Helplessness and frustration from lack of glycaemic control (Nagelkerk et al. 2006) -Stress, frustration, social isolation, interpersonal conflicts, depression and fear (Gazmararian et al. 2009) -Fear and hypoglycaemic attacks (Wild et al. 2007) -Depression (Jerant et al. 2005, Egede & Ellis 2008) and psychosocial distress (Chiechanowski et al. 2000) -Gender differences (Fitzgerald et al. 1995, Sousa & Zauszniewski 2005, Whittemore et al. 2005, Tang et al. 2008) -Positive attitudes towards diabetes (Zhong et al. 2011) -Beliefs about illness (Harvey & Lawson 2009) -Self-care skills (Tang et al. 2008) -Problems with weight, difficulty exercising, fatigue, low family support (Jerant et al. 2005) -Personal values, problem-solving skills and ability to accept responsibility (Williams et al. 2008) -Age, motivation, understanding of disease (Dalewitz et al. 2000) "
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    ABSTRACT: AimTo describe a protocol for a quantitative systematic review, to identify critique and summarize factors that influence self-management education. Background Self-management education enables patients to manage their condition successfully and it is associated with better self-care, good control over lifestyle and leading the best possible quality of life, notwithstanding the presence of a chronic disease. Type II Diabetes is a chronic disease that requires lifestyle adjustments and disease management to keep glycaemia and long-term complications under control. Education has to be customized and based on an assessment that includes factors influencing self-management, such as personal characteristics that can optimize the educational intervention. DesignThe protocol for the systematic review was conducted according to the guidelines of the Centre for Reviews and Dissemination, York (UK). Method The review question was defined in terms of population, interventions, comparators, outcomes and study designs. The protocol included decisions about the review question, inclusion criteria, search strategy, study selection, data extraction, quality assessment, data synthesis and plans for dissemination. Funding for the review was confirmed on January 2011 by the Centre of Excellence for Nursing Scholarship in Rome. DiscussionAn initial summary will be made by tabulating the data; the review will be reported in a narrative style and be developed according to the PRISMA guidelines. The protocol for the systematic review will allow us to identify, among the factors influencing self-management in people with Type II diabetes, the personal characteristics most relevant to the factors of motivation and empowerment. In addition, the systematic review will also identify an appropriate self-management model.
    Journal of Advanced Nursing 06/2013; 70(1). DOI:10.1111/jan.12178 · 1.69 Impact Factor
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    • "Self-care (a focus on prevention or maintenance) The outcomes/goals of SC were specified in broad terms, such as the prevention of disease, limitation of illness and restoration of health, changes in lifestyle, maintenance of optimal levels of health (Eales & Stewart 2001), the maintenance of a satisfactory quality of life (Barlow et al. 2002), health and well-being (Artinian et al. 2002). More specific outcomes include staying fit and maintaining good physical and mental health, meeting of social and psychological needs, the prevention of illness or accidents, care for minor ailments and long-term conditions, and maintain health and well-being after an acute illness or discharge from hospital (Department of Health 2005). "
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    ABSTRACT: jones mc, macgillivray s, kroll t, zohoor ar & connaghan j (2011) Journal of Nursing and Healthcare of Chronic Illness3, 174–185 A thematic analysis of the conceptualisation of self-care, self-management and self-management support in the long-term conditions management literature Aim. To conduct a thematic analysis of the conceptualisation of self-care in the chronic illness management literature. Background. The growing prevalence of chronic illness is an increasing challenge for health and social-care services that attempt to better support self-care and self-management. There is currently a lack of consensus about the meaning and usage of these terms in a rapidly expanding research and policy literature. This may hinder the service innovation based on such policy imperative and evidence. Methods. An iterative literature search was performed, across a wide variety of research databases, using the existing subject headings ‘self-care’ and ‘chronic disease’. Publications (1995–2008) were included if they had a primary focus on self-care or self-management of a long-term condition and provided some form of definition for these concepts. Publications were subject to systematic data extraction and subsequent thematic analysis. Results. The search resulted in 1469 publications, of which 247 were included. Publications represented a wide range of quantitative and qualitative designs focused on several long-term condition areas. Definitions of self-care (SC), self-management (SM) and self-management support (SMS) were multidimensional and varied as to who is involved, what is entailed and what is achieved. Whilst overlap exists, it is the nature of the networks involved (broad, focused or co-ordinated), the imperative for action (optional, unavoidable or essential), and the goals to be achieved (maintenance, coping or facilitation) that conceptually distinguish self-care, self-management and self-management support. Conclusions. Definitions of self-care, self-management and self-management support are complex and multidimensional. Key conceptual distinctions can be made between these terms suggesting that they can be applied with greater consistency and precision in practice, policy and research. Relevance to clinical practice. Future research must use these terms with greater precision to allow comparisons of the differential effectiveness of intervention programmes in long-term conditions.
    Journal of Nursing and Healthcare of Chronic Illness 08/2011; 3(3):174 - 185. DOI:10.1111/j.1752-9824.2011.01096.x
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