Korean J Adult Nurs.  2016 Jun;28(3):302-313. 10.7475/kjan.2016.28.3.302.

Influence of Social Support and Negative Emotional Status on Self-care Adherence in Symptomatic Patients with Heart Failure

• Yang IS

• KMID: 2312163
• DOI: http://doi.org/10.7475/kjan.2016.28.3.302

Abstract

PURPOSE
The objective of this study was to identify factors related to self-care adherence in symptomatic patients with heart failure (HF).
METHODS
Using a cross-sectional design, a convenience sample 209 outpatient clinic patients were recruited at two medical centers. Between October 2011 and August 2012, data were collected using the structured questionnaire. Factors related to self-care adherence were examined using hierarchical multiple regression.
RESULTS
Mean age of participants was 67.71 years and a half of them (53.6%) were female. They showed relatively low self-care adherence with mean scores of 61.88±12.92. Lower self-care adherence was reported in asking for low sodium items, weighing oneself, checking for ankle edema, and exercising for 30 minutes. The overall model significantly explained 23.9% of variance in self-care adherence. Among the predictors, education, New York Heart Association functional classification, and social support were statistically significant in influencing self-care adherence. The variable of negative emotional status such as anxiety and depression were not found to be significant.
CONCLUSION
These findings demonstrate that social support could help self-care adherence among symptomatic patients with HF. Thus, programs targeting self-care adherence in this population should consider the strategies improving social support.

MeSH Terms

Ambulatory Care Facilities
Ankle
Anxiety
Classification
Depression
Edema
Education
Female
Heart Failure*
Heart*
Humans
Self Care*
Sodium
Sodium

Reference

1.The Korean of Heart Failure. The manual of heart failure. Seoul: MMK comunications;2007. p. 11–36.

2.National Health Insurance Service. 『Heart Failure』 Over 80 years have 14 times higher HF patient rate than average [Internet]. Seoul: National Health Insurance Service;2014. [cited 2015 July 1]. Available from:. http://www.nhis.or.kr/bbs7/boards/B0039/3171.

3.Mavrea AM., Dragomir T., Bordejevic DA., Tomescu MC., Ancu-sa O., Marincu I. Causes and predictors of hospital readmissions in patients older than 65 years hospitalized for heart failure with preserved left ventricular ejection fraction in western Romania. Clinical Interventions in Aging. 2015. 17:979–90. http://dx.doi.org/10.2147/CIA.S83750.

4.Rodríguez Artalejo F., Guallar-Castillón P., Montoto Otero C., Conde Herrera M., Carreño Ochoa C., Tabuenca Martín AI, et al. Self-care behavior and patients' knowledge about self-care predict rehospitalization among older adults with heart failure. Revista Clínica Española. 2008. 208(6):269–75.

5.Tsuchihashi-Makaya M., Kato N., Chishaki A., Takeshita A., Tsu-tsui H. Anxiety and poor social support are independently associated with adverse outcomes in patients with mild heart failure. Circulation Journal. 2009. 73(2):280–7. http://dx.doi.org/10.1253/circj.cj-08-0625.

6.Heo S., Moser DK., Lennie TA., Riegel B., Chung ML. Gender differences in and factors related to self-care behaviors: a cross-sectional, correlational study of patients with heart failure. International Journal of Nursing Studies. 2008. 45(12):1807–15. http://dx.doi.org/10.1016/j.ijnurstu.2008.05.008.

7.Riegel B., Moser DK., Anker SD., Appel LJ., Dunbar SB., Grady KL, et al. State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association. Circulation. 2009. 120(12):1141–63. http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192628.

8.Schnell-Hoehn KN., Naimark BJ., Tate RB. Determinants of self-care behaviors in community-dwelling patients with heart failure. Journal of Cardiovascular Nursing. 2009. 24(1):40–7. http://dx.doi.org/10.1097/01.JCN.0000317470.58048.7b.

9.Son YJ., Kim SH., Kim GY. Factors influencing adherence to self-care in patients with chronic heart failure. Korean Journal of Adult Nursing. 2011. 23(3):244–54.

10.Hu X., Hu X., Su Y., Qu M., Dolansky MA. The changes and factors associated with post-discharge self-care behaviors among Chinese patients with heart failure. Patient Preference and Adherence. 2015. 9:1593–601. http://dx.doi.org/10.2147/PPA.S88431.

11.Maeda U., Shen BJ., 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(1):88–96. http://dx.doi.org/10.1007/s12529-011-9215-0.

12.Oxman TE., Hull JG. Social support, depression, and activities of daily living in older heart surgery patients. The Journal of Gerontology. Series B, Psychological Sciences and Social Sciences. 1997. 52B(1):P1–14.

13.Fortmann AL., Gallo LC., Philis-Tsimikas A. Glycemic control among Latinos with type 2 diabetes: the role of social-environmental support resources. Health Psychology. 2011. 30(3):251–8. http://dx.doi.org/10.1037/a0022850.

14.Heo S., Moser DK., Chung ML., Lennie TA. Social status, health-related quality of life, and event-free survival in patients with heart failure. European Journal of Cardiovascular Nursing. 2012. 11(2):141–9. http://dx.doi.org/10.1016/j.ejcnurse.2010.10.003.

15.Gallagher R., Luttik ML., Jaarsma T. Social support and self-care in heart failure. Journal of Cardiovascular Nursing. 2011. 26(6):439–45. http://dx.doi.org/10.1097/JCN.0b013e31820984e1.

16.Lee ES., Shin ES., Hwang SY., Chae MJ., Jeong MH. Effects of tailored supportive education on physical, emotional status and quality of life in patients with congestive heart failure. Korean Journal of Adult Nursing. 2013. 25(1):62–73. http://dx.doi.org/10.7475/kjan.2013.25.1.62.

17.Khaledi GH., Mostafavi F., Eslami AA., Rooh Afza H., Mostafavi F., Akbar H. Evaluation of the effect of perceived social support on promoting self-care behaviors of heart failure patients referred to the Cardiovascular Research Center of Isfahan. Iranian Red Crescent Medical Journal. 2015. 17(6):e22525–31. http://dx.doi.org/10.5812/ircmj.22525v2.

18.Goodman H., Firouzi A., Banya W., Lau-Walker M., Cowie MR. Illness perception, self-care behaviour and quality of life of heart failure patients: a longitudinal questionnaire survey. International Journal of Nursing Studies. 2013. 50(7):945–53. http://dx.doi.org/10.1016/j.ijnurstu.2012.11.007.

19.Morgan K., Villiers-Tuthill A., Barker M., McGee H. The contribution of illness perception to psychological distress in heart failure patients. BMC Psychology. 2014. 2(1):50–8. http://dx.doi.org/10.1186/s40359-014-0050-3.

20.Barrera M Jr.., Sandler IN., Ramsay TB. Preliminary development of a scale of social support: studies on college students. American Journal of Community Psychology. 1981. 9(4):435–47. http://dx.doi.org/10.1007/BF00918174.

21.Finch JF., Barrera M Jr., Okun MA., Bryant WHM., Pool GJ. Snow-Turek AL. Factor structure of received social support: dimensionality and the prediction of depression and life satisfaction. Journal of Social and Clinical Psychology. 1997. 16(3):323–42.

22.Zigmond AS., Snaith RP. The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica. 1983. 67(6):361–70.

23.Oh SM., Min KJ., Park DB. A study on the standardization of the Hospital Anxiety and Depressed Scale for Koreans-a comparison of normal, depressed and anxious groups. Journal of Korean Neuropsychiatric Association. 1999. 38(2):289–96.

24.Riegel B., Carlson B., Moser DK., Sebern M., Hicks FD., Roland V. Psychometric testing of the self-care of heart failure index. Journal of Cardiac Failure. 2004. 10(4):350–60. http://dx.doi.org/10.1016/j.cardfail.2003.12.001.

25.Riegel B., Lee CS., Dickson VV., Carlson B. An update on the self-care of heart failure index. Journal of Cardiovascular Nursing. 2009. 24(6):485–97. http://dx.doi.org/10.1097/JCN.0b013e3181b4baa0.

26.Levy BR., Hausdorff JM., Hencke R., Wei JY. Reducing cardiovascular stress with positive self-stereotypes of aging. The Journal of Gerontology. Series B, Psychological Sciences and Social Sciences. 2000. 55(4):P205–13.

27.Damen NL., Pelle AJ., Szabó BM., Pedersen SS. Symptoms of anxiety and cardiac hospitalizations at 12 months in patients with heart failure. Journal of General Internal Medicine. 2012. 27(3):345–50. http://dx.doi.org/10.1007/s11606-011-1843-1.

28.Shimizu Y., Suzuki M., Okumura H., Yamada S. Risk factors for onset of depression after heart failure hospitalization. Journal of Cardiology. 2014. 64(1):37–42. http://dx.doi.org/10.1016/j.jjcc.2013.11.003.

29.Cocchieri A., Riegel B., D'Agostino F., Rocco G., Fida R., Alvaro R, et al. Describing self-care in Italian adults with heart failure and identifying determinants of poor self-care. European Journal of Cardiovascular Nursing. 2015. 14(2):126–36. http://dx.doi.org/10.1177/1474515113518443.

30.Graven LJ., Grant JS. Social support and self-care behaviors in individuals with heart failure: an integrative review. International Journal of Nursing Studies. 2014. 51(2):320–33. http://dx.doi.org/10.1016/j.ijnurstu.2013.06.013.