Relationship between self-care and health-related quality of life in older adults with moderate to advanced heart failure

Harleah G. Buck, Christopher S. Lee, Debra K. Moser, Nancy M. Albert, Terry Lennie, Brooke Bentley, Linda Worrall-Carter, Barbara Riegel

Research output: Contribution to journalArticle

55 Scopus citations

Abstract

Background: Heart failure (HF) patients who follow the treatment regimen and attend to symptoms before they escalate are assumed to have better health-related quality of life (HRQOL) than those with poor self-care, but there are few data available to support or refute this assumption. Objective: The objective of the study was to describe the relationship between HF self-care and HRQOL in older (≥65 years old) adults with moderate to advanced HF. Methods: Self-care was measured using the 3 scales (maintenance, management, and confidence) of the Self-care of Heart Failure Index. Scores range from 0 to 100, with higher numbers indicating better self-care. Health-related quality of life was measured with the Minnesota Living With Heart Failure Questionnaire, a 2-subscale (physical and emotional) instrument. Lower numbers on the Minnesota Living With Heart Failure Questionnaire indicate better HRQOL. Pearson correlations, independent-samples t-tests, and linear and logistic regression modeling were used in the analysis. Results: In 207 adults (72.9 [SD, 6.3] years), New York Heart Association class III (82%) or IV, significant linear associations were observed between self-care confidence and total (r = -0.211; P = .002), physical (r = -0.189; P = .006), and emotional HRQOL (r = -0.201; P = .004). Patients reporting better (below median) HRQOL had higher confidence scores compared with patients reporting above-median HRQOL scores (58.8 [19.2] vs 52.8 [19.6]; P = .028). Confidence was an independent determinant of total (βs = -3.191; P = .002), physical (βs = -2.346; P = .002), and emotional (βs = -3.182; P = .002) HRQOL controlling for other Self-care of Heart Failure Index scores, age, gender, and New York Heart Association class. Each 1-point increase in confidence was associated with a decrease in the likelihood that patients had worse (above median) HRQOL scores (odds ratio, 0.980 [95% confidence interval, 0.963-0.998]) with the same controls. No significant associations were found between self-care maintenance or management and HRQOL. Conclusions: The degree of individual confidence in HF self-care is related to HRQOL, but self-reports of specific maintenance and management behaviors are not. Interventions that improve self-care confidence may be particularly important in older adults with moderate to advanced HF.

Original languageEnglish (US)
Pages (from-to)8-15
Number of pages8
JournalJournal of Cardiovascular Nursing
Volume27
Issue number1
DOIs
StatePublished - Jan 2012

Keywords

  • confidence
  • heart failure
  • quality of life
  • self-care
  • self-efficacy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

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    Buck, H. G., Lee, C. S., Moser, D. K., Albert, N. M., Lennie, T., Bentley, B., Worrall-Carter, L., & Riegel, B. (2012). Relationship between self-care and health-related quality of life in older adults with moderate to advanced heart failure. Journal of Cardiovascular Nursing, 27(1), 8-15. https://doi.org/10.1097/JCN.0b013e3182106299