Korean J Adult Nurs.  2015 Apr;27(2):242-250. 10.7475/kjan.2015.27.2.242.

Factors Affecting Adherence to Self-care Behaviors among Outpatients with Heart Failure in Korea

• Ok JS
• Choi H

• KMID: 2298138
• DOI: http://doi.org/10.7475/kjan.2015.27.2.242

Abstract

PURPOSE
To evaluate heart failure knowledge and adherence to self-care behaviors, and to identify factors affecting adherence to self-care behaviors among Korean patients with heart failure.
METHODS
Correlational research using the European Heart Failure Self-care Behavior Scale, the Duke Activity Status Index, the Dutch Heart Failure Knowledge Scale, the New York Heart Association Functional Classification, and the Medical Outcomes Study Social Support Survey was conducted. A total of 280 outpatients with heart failure responded to the five questionnaires.
RESULTS
The mean scores for self-care adherence and heart failure knowledge were 31.98 +/- 6.81 and 8.78 +/- 2.53, respectively, indicating lower adherence and knowledge than those previously reported. Subjects with lower functional status, more social supports, and greater knowledge of heart failure are more likely to adhere to prescribed regimens.
CONCLUSION
Nurses should focus on patient education and support to improve their adherence to self-care behaviors.

MeSH Terms

Classification
Heart
Heart Failure*
Humans
Korea
Outpatients*
Patient Compliance
Patient Education as Topic
Self Care*
Surveys and Questionnaires

Reference

1.The KoreanSociety of Heart Failure. Heartfailure manual. Seoul: The Korean Society of Heart Failure;2007. p. 18–21.

2.Choi D., Han S., Jeon E., Cho M., Kim J., Yoo B, et al. Characteristics, outcomes and predictors of long-term mortality for patients hospitalized for acute heart failure: a report from the Koreanheartfailure registry. KoreanCirculation Journal. 2011. 41:363–71. http://dx.doi.org/10.4070/kcj.2011.41.7.363.

3.Yancy C., Jessup M., Bozkurt B., Butler J., Casey D Jr., Drazner M, et al. 2013 ACCF/AHA guideline for the management of heart failure: executive summary: a report of the american college of cardiology Foundation/American heart association task force on practice guidelines. Circulation. 2013. 128:1810–52. http://dx.doi.org/10.1161/CIR.0b013e31829e8807.

4.Michalsen A., Konig G., Thimme W. Preventable causative factors leading to hospital admission with decompensated heart failure. Heart. 1998. 80:437–41. http://dx.doi.org/10.1136/hrt.80.5.437.

5.Happ M., Naylor M., Roe-Prior P. Factors contributing to rehospitalization of elderly patients with heart failure. Journal of Cardiovascular Nursing. 1997. 11:75–84.

6.Krumholz H., Amatruda J., Smith G., Mattera J., Roumanis S., Radford M, et al. Randomized trial of an education and sup-portinterventionto preventreadmission of patients withheart failure. Journal of the American College of Cardiology. 2002. 39:83–9. http://dx.doi.org/10.1016/S0735-1097(01)01699-0.

7.Riegel B., Moser D., Anker S., Appel L., Dunbar S., Grady K, et al. Stateofthe science: promotingself-care in persons with heart failure: ascientific statementfrom the AmericanHeartAssoci-ation. Circulation. 2009. 120:1141–63. http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192628.

8.Heart Failure Society of America. Executive summary: HFSA 2006 comprehensive heart failure practice guideline. Journal of Cardiac Failure. 2006. 12:10–38. http://dx.doi.org/10.1016/j.cardfail.2005.12.001.

9.Carlson B., Riegel B., Moser D. Self-careabilities of patients with heart failure. Heart & Lung. 2001. 30:351–9. http://dx.doi.org/10.1067/mhl.2001.118611.

10.Rockwell J., Riegel B. Predictors of self-care in persons with heart failure. Heart & Lung. 2001. 30:18–25. http://dx.doi.org/10.1067/mhl.2001.112503.

11.Chriss P., Sheposh J., Carlson B., Riegel B. Predictors of successful heart failure self-care maintenance in the first three months after hospitalization. Heart & Lung. 2004. 33:345–53. http://dx.doi.org/10.1016/j.hrtlng.2004.03.004.

12.Heo S., Moser D., Lennie T., Riegel B., Chung M. Gender differences in andfactors related toself-care behaviors: a cross-sectional, correlational study of patients with heart failure. International Journal of Nursing Studies. 2008. 45:1807–15. http://dx.doi.org/10.1016/j.ijnurstu.2008.05.008.

13.Chen A., Yehle K., Albert N., Ferraro K., Mason H., Murawski M, et al. Relationships between health literacy and heart failure knowledge, self-efficacy, and self-care adherence. Research in Social & Administrative Pharmacy. 2014. 10:378–86. http://dx.doi.org/10.1016/j.sapharm.2013.07.001.

14.Sayers S., Riegel B., Pawlowski S., Coyne J., Samaha F. Social support and self-care of patients with heart failure. Annals of Behavioral Medicine. 2008. 35:70–9. http://dx.doi.org/10.1007/s12160-007-9003-x.

15.Maeda U., Shen B-J., Schwarz ER., Farrell KA., Mallon S. Self-efficacy mediates the associations of social support and depression with treatment adherence in heart failure patients. International Journal of Behavioral Medicine. 2013. 20:88–96. http://dx.doi.org/10.1007/s12529-011-9215-0.

16.van der Wal M., Jaarsma T., van Veldhuisen D. Non-compliance in patients with heart failure; howcan we manage it? European Journal of Heart Failure. 2005. 7:5–17. http://dx.doi.org/10.1016/j.ejheart.2004.04.007.

17.Faul F., Erdfelder E., Buchner A., Lang A. Statisticalpower anal-ysesusingGPower3.1: testfor correlationandregressionana-lyses. Behavior Research Methods. 2009. 41:1149–60. http://dx.doi.org/10.3758/BRM.41.4.1149.

18.Jaarsma T., Stromberg A., Martensson J., Dracup K. Development andtesting ofthe European heartfailure self-care behaviour scale. European Journal of Heart Failure. 2003. 5:363–70. http://dx.doi.org/10.1016/S1388-9842(02)00253-2.

19.van der Wal M., Jaarsma T., Moser D., van Veldhuisen D. Development and testing of the Dutch heart failure knowledge scale. European Journal of Cardiovascular Nursing. 2005. 4:273–7. http://dx.doi.org/10.1016/j.ejcnurse.2005.07.003.

20.McDowell I. Measuring health: a guide to rating scales and questionnaires. 3rd ed.New York: Oxford University Press;2006. p. 165–7.

21.Sherbourne C., Stewart A. The MOS social support survey. Social Science & Medicine. 1991. 32:705–14. http://dx.doi.org/10.1016/0277-9536(91)90150-B.

22.Bennett J., Riegel B., Bittner V., Nichols J. Validity andreliability of the NYHA classes for measuring research outcomes in patients with cardiac disease. Heart & Lung. 2002. 31:262–70. http://dx.doi.org/10.1067/mhl.2002.124554.

23.Arena R., Humphrey R., Peberdy M. Using the Duke Activity Status Index in heart failure. Journal of Cardiopulmonary Rehabilitation. 2002. 22:93–5.

24.Kato N., Kinugawa K., Ito N., Yao A., Watanabe M., Imai Y, et al. Adherenceto self-care behavior and factors related tothis behavior among patients with heart failure in Japan. Heart & Lung. 2009. 38:398–409. http://dx.doi.org/10.1016/j.hrtlng.2008.11.002.

25.Hwang B., Moser D., Dracup K. Knowledge is insufficient for self-care among heart failure patients with psychological distress. Journal of Health Psychology. 2014. 33:588–96. http://dx.doi.org/10.1037/a0033419.

26.van der Wal M., Jaarsma T., Moser D., Veeger N., van Gilst W., van Veldhuisen D. Compliance in heart failure patients: the importance of knowledge and beliefs. European Heart Journal. 2006. 27:434–40. http://dx.doi.org/10.1093/eurheartj/ehi603.

27.Cocchieri A., Riegel B., D'Agostino F., Rocco G., Fida R., Alvaro R, et al. Describing self-care in Italian adults with heartfailure and identifying determinants of poor selfcare. European Journal of Cardiovascular Nursing. 2015. 14:126–36. http://dx.doi.org/10.1177/1474515113518443.

28.Chen A., Yehle K., Albert N., Ferraro K., Mason H., Murawski M, et al. Health literacy influences heart failure knowledge at-tainmentbutnotself-efficacy for self-care oradherence toself-care over time. Nursing Research &Practice. 2013. ID353290:1–8. http://dx.doi.org/10.1155/2013/353290.

29.Baker D., Asch S., Keesey J., Brown J., Chan K., Joyce G, et al. Differences in education, knowledge, self-management activities, and health outcomes for patients with heart failure cared for under the chronic disease model: the improving chronic illness care evaluation. Journal of Cardiac Failure. 2005. 11:405–13. http://dx.doi.org/10.1016/j.cardfail.2005.03.010.