From novice to expert: Confidence and activity status determine heart failure self-care performance

Barbara Riegel, Christopher Lee, Nancy Albert, Terry Lennie, Misook Chung, Eun Kyeung Song, Brooke Bentley, Seongkum Heo, Linda Worrall-Carter, Debra K. Moser

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Background: In a previous, small, mixed-methods study, heart failure patients were described as novice, expert, or inconsistent in self-care. In that study, self-care types differed in experience, confidence, attitudes, and skill. Objectives: The aims of this study were to validate the novice-to-expert self-care typology and to identify determinants of the heart failure self-care types. Methods: A cross-sectional descriptive study was performed using data from 689 adults with heart failure (61 ± 2.5 years; 36% female, 50% New York Heart Association class III). Two-step likelihood cluster analysis was used to classify patients into groups using all items in the maintenance and management scales of the Self-care of Heart Failure Index. Multinomial regression was used to identify the determinants of each self-care cluster, testing the influence of age, gender, left ventricular ejection fraction, body mass index, depression, anxiety, hostility, perceived control, social support, activity status (Duke Activity Status Index), and self-care confidence. Results: Self-care behaviors clustered best into three types: novice (n = 185, 26.9%), expert (n = 229, 33.2%), and inconsistent (n = 275, 39.9%). The model predicting self-care cluster membership was significant (χ = 88.67, p <.001); Duke Activity Status Index score and Self-care of Heart Failure Index confidence score were the only significant individual factors. Higher activity status increased the odds that patients would be inconsistent (odds ratio [OR] = 1.02-1.09) or novice (OR = 1.02-1.10) in self-care. Higher self-care confidence increased the odds of being an expert (OR = 1.05-1.09) or inconsistent (OR = 1.01-1.05) in self-care. Discussion: The three-level typology of heart failure self-care was confirmed. Patients who have fewer limitations to daily activities may not be driven adequately to engage in heart failure self-care and may need extra assistance in developing expertise.

Original languageEnglish (US)
Pages (from-to)132-138
Number of pages7
JournalNursing Research
Volume60
Issue number2
DOIs
StatePublished - Mar 2011

Fingerprint

Self Care
Heart Failure
Odds Ratio
Hostility
Social Support
Stroke Volume
Cluster Analysis
Body Mass Index
Anxiety

Keywords

  • activity status
  • confidence
  • heart failure
  • self-care

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Riegel, B., Lee, C., Albert, N., Lennie, T., Chung, M., Song, E. K., ... Moser, D. K. (2011). From novice to expert: Confidence and activity status determine heart failure self-care performance. Nursing Research, 60(2), 132-138. https://doi.org/10.1097/NNR.0b013e31820978ec

From novice to expert : Confidence and activity status determine heart failure self-care performance. / Riegel, Barbara; Lee, Christopher; Albert, Nancy; Lennie, Terry; Chung, Misook; Song, Eun Kyeung; Bentley, Brooke; Heo, Seongkum; Worrall-Carter, Linda; Moser, Debra K.

In: Nursing Research, Vol. 60, No. 2, 03.2011, p. 132-138.

Research output: Contribution to journalArticle

Riegel, B, Lee, C, Albert, N, Lennie, T, Chung, M, Song, EK, Bentley, B, Heo, S, Worrall-Carter, L & Moser, DK 2011, 'From novice to expert: Confidence and activity status determine heart failure self-care performance', Nursing Research, vol. 60, no. 2, pp. 132-138. https://doi.org/10.1097/NNR.0b013e31820978ec
Riegel, Barbara ; Lee, Christopher ; Albert, Nancy ; Lennie, Terry ; Chung, Misook ; Song, Eun Kyeung ; Bentley, Brooke ; Heo, Seongkum ; Worrall-Carter, Linda ; Moser, Debra K. / From novice to expert : Confidence and activity status determine heart failure self-care performance. In: Nursing Research. 2011 ; Vol. 60, No. 2. pp. 132-138.
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