With the aging of the population, chronic conditions such as heart failure are becoming more prevalent. An important goal is to understand how patients with heart failure learn to manage their debilitating disease symptoms. Schnell-Hoehn and colleagues examined the determinants of general and therapeutic self-care behaviors among community-dwelling heart failure patients. Guided by Connelly's Model of Self-care in Chronic Illness, enabling and predisposing factors were evaluated using sociodemographic characteristics, functional ability, and psychological status. Self-care maintenance, self-efficacy, and self-care management characteristics were also evaluated. Using a cross-sectional design, a convenience sample of 65 ambulatory care patients was recruited. Data were collected through chart reviews and questionnaires. Common self-care maintenance behaviors included taking medication as prescribed (95%), seeking physician guidance (80%), and following sodium dietary restrictions (70%). Enabling characteristics such as psychological status, ethnicity, and comorbidity influenced these behaviors. A unique finding was that self-care maintenance behaviors were significantly lower in aboriginal participants. The predisposing characteristic of self-efficacy influenced self-maintenance behaviors, overall self-care, and number of hospital admissions. Higher overall self-care scores, measured by the summative Self-care Heart Failure Index score, were correlated with fewer hospital admissions.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The study pinpointed determinants of self-care behaviors in patients with heart failure. These factors should be considered if you are planning on developing and implementing a self-management program for heart failure.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: If you have experienced heart failure, you might want to consider the factors found in this study as perhaps affecting your ability to use self-management skills. The information might be useful to know before you are enrolled in a self-management program.

KN Schnell-Hoehn et al. Determinants of self-care behaviors in community-dwelling patients with heart failure. Journal of Cardiovascular Nursing, 2009;24:40-47.