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Determinants of heart failure self-care behaviour in community-based patients: a cross-sectional study

Research output: Contribution to journalJournal article

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  • F. Peters-Klimm
  • T. Freund
  • Cornelia U. Kunz
  • G. Laux
  • L. Frankenstein
  • T. Müller-Tasch
  • J. Szecsenyi
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<mark>Journal publication date</mark>04/2013
<mark>Journal</mark>European Journal of Cardiovascular Nursing
Issue number2
Volume12
Number of pages10
Pages (from-to)167-176
Publication statusPublished
Early online date18/04/12
Original languageEnglish

Abstract

BACKGROUND: Self-care behaviour in patients with heart failure (HF) represents a series of specific actions that patients should take, as an important treatment component.

AIMS: The aim of this study was to identify potential determinants of HF self-care in ambulatory patients with stable systolic HF.

METHODS: In a cross-sectional study of 318 patients with chronic systolic HF recruited in 48 German primary care practices, we evaluated the patient-reported European HF Self-care Behaviour scale (EHFScBs) assessments (range 12-60, where lower scores indicate better self-care). Potential determinants included socio-demographic (e.g. age, living status), clinical (e.g. NYHA class, LVEF, NT-proBNP levels, co-morbidities), behavioural (e.g. smoking and alcohol intake), psychosocial (SF-36 scales and KCCQ domains, e.g. quality of life and self-efficacy) and depression status (PHQ-D), plus previous health care utilisation. Mixed regression modelling was applied.

RESULTS: Patients had a mean (SD) age of 69.0 (10.4) years and were 71% male. They had a good overall EHFScBs score of 24.7 (7.8) (n=274). In the final regression model (n=271), six determinants were retained (β; descriptive p-value): self-efficacy (-0.24; <.001), age (-0.22; <.001), prosthetic heart valve (-0.14; .01), referrals to cardiologists (-0.14; .02), peripheral arterial disease (0.13; .03) and quality of life (0.16; .02).

CONCLUSION: In this exploratory cross-sectional study, the potential non-modifiable and modifiable risk factors and resources involved in patients' HF self-care were at the individual and organisational level. Self-efficacy and quality of life are potentially modifiable, so these could be targeted for improvement by enhancing patient motivation, HF education and further supporting a collaborative care approach.