Skip to main content
Article
Relationship Between Self-care and Health-Related Quality of Life in Older Adults With Moderate to Advanced Heart Failure
The Journal of Cardiovascular Nursing
  • Harleah G. Buck, Pennsylvania State University
  • Christopher S. Lee, Oregon Health & Science University
  • Debra K. Moser, University of Kentucky
  • Nancy M. Albert, Kaufman Center for Heart Failure
  • Terry Lennie, University of Kentucky
  • Brooke Bentley, Eastern Kentucky University
  • Linda Worrall-Carter, Australian Catholic University
  • Barbara Riegel, University of Pennsylvania
Document Type
Article
Publication Date
1-1-2012
Keywords
  • confidence,
  • heart failure,
  • quality of life,
  • self-care,
  • self-efficacy
Digital Object Identifier (DOI)
http://dx.doi.org/10.1097/JCN.0b013e3182106299
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 ([beta]s = -3.191; P = .002), physical ([beta]s = -2.346; P = .002), and emotional ([beta]s = -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. 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 ([beta]s = -3.191; P = .002), physical ([beta]s = -2.346; P = .002), and emotional ([beta]s = -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.
Citation / Publisher Attribution

The Journal of Cardiovascular Nursing, v. 27, issue 1, p. 8-15

Citation Information
Harleah G. Buck, Christopher S. Lee, Debra K. Moser, Nancy M. Albert, et al.. "Relationship Between Self-care and Health-Related Quality of Life in Older Adults With Moderate to Advanced Heart Failure" The Journal of Cardiovascular Nursing Vol. 27 Iss. 1 (2012) p. 8 - 15
Available at: http://works.bepress.com/harleah-buck/25/