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      Heart failure self-care, factors influencing self-care and the relationship with health-related quality of life: A cross-sectional observational study

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          Abstract

          Background

          Self-care helps maintain health, prevents complications and improves the quality of life of patients living with heart failure (HF). Self-care is critical to HF management but has received limited attention in Nepal. Identification of the sociodemographic and clinical characteristics associated with self-care is crucial to tailoring appropriate self-care programs to improve health outcomes including patients’ quality of life.

          Aims

          The aims of this study were to describe self-care including the factors influencing self-care and the relationship between self-care and health-related quality of life in patients living with HF in Kathmandu, Nepal.

          Methods

          We used a cross-sectional observational study design to measure self-care maintenance, self-care management, and self-care confidence using the Nepali Self-Care of Heart Failure Index. To analyze data, we used descriptive statistics, bivariate associations and regression modeling.

          Results

          We recruited 221 patients with HF: mean age 57.5 ± 15.76 years, 62% male. The results in this sample indicated poor self-care maintenance (38.5 ± 11.56), management (45.7 ± 15.14), and confidence (40.9 ± 16.31). Patients with higher education were associated with higher self-care maintenance and management. Living alone and a better New York Heart Association functional classification for HF were related to higher self-care confidence. Higher social support was associated with better self-care. Self-care confidence was an independent predictor of self-care maintenance, management and health-related quality of life on adjusted analyses.

          Conclusion

          Self-care was limited among patients living with HF in Nepal yet was associated with better quality of life. The study identified various sociodemographic and clinical factors related to self-care, which could be crucial while developing self-care interventions.

          Abstract

          Public health; Cardiovascular system; Clinical research; Nursing; Health services; Factors; Heart failure; Quality of life; Self-care; Self-management.

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          Most cited references34

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          An update on the self-care of heart failure index.

          The Self-care of Heart Failure Index (SCHFI) is a measure of self-care defined as a naturalistic decision-making process involving the choice of behaviors that maintain physiological stability (maintenance) and the response to symptoms when they occur (management). In the 5 years since the SCHFI was published, we have added items, refined the response format of the maintenance scale and the SCHFI scoring procedure, and modified our advice about how to use the scores. The objective of this article was to update users on these changes. In this article, we address 8 specific questions about reliability, item difficulty, frequency of administration, learning effects, social desirability, validity, judgments of self-care adequacy, clinically relevant change, and comparability of the various versions. The addition of items to the self-care maintenance scale did not significantly change the coefficient alpha, providing evidence that the structure of the instrument is more powerful than the individual items. No learning effect is associated with repeated administration. Social desirability is minimal. More evidence is provided of the validity of the SCHFI. A score of 70 or greater can be used as the cut-point to judge self-care adequacy, although evidence is provided that benefit occurs at even lower levels of self-care. A change in a scale score more than one-half of an SD is considered clinically relevant. Because of the standardized scores, results obtained with prior versions can be compared with those from later versions. The SCHFI v.6 is ready to be used by investigators. By publication in this format, we are putting the instrument in the public domain; permission is not required to use the SCHFI.
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            The Situation-Specific Theory of Heart Failure Self-Care: Revised and Updated.

            Since the situation-specific theory of heart failure (HF) self-care was published in 2008, we have learned much about how and why patients with HF take care of themselves. This knowledge was used to revise and update the theory.
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              • Article: not found

              Heart failure: preventing disease and death worldwide

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                Author and article information

                Contributors
                Journal
                Heliyon
                Heliyon
                Heliyon
                Elsevier
                2405-8440
                17 February 2020
                February 2020
                17 February 2020
                : 6
                : 2
                : e03412
                Affiliations
                [a ]School of Nursing, Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD 21205 United States
                [b ]Division of Health Sciences Informatics, Johns Hopkins University School of Medicine, 2024 E Monument St, Baltimore, MD 21205 United States
                Author notes
                []Corresponding author. bkoiral1@ 123456jhu.edu
                Article
                S2405-8440(20)30257-7 e03412
                10.1016/j.heliyon.2020.e03412
                7031642
                32149197
                43b59176-d426-4800-b86a-e0e304f79412
                © 2020 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 18 May 2019
                : 31 October 2019
                : 10 February 2020
                Categories
                Article

                public health,cardiovascular system,clinical research,nursing,health services,factors,heart failure,quality of life,self-care,self-management

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