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Investigation the relationship between self-care and readmission in patients with chronic heart failure.

ABSTRACT: BACKGROUND: Chronic heart failure (CHF) is associated with unpredictably increased prevalence of hospital admissions. Self-care is one of the most important aspects of management for patients with CHF. Self-care adequacy has led to increased satisfaction, independence in daily activities, reduced stress, and morbidity. OBJECTIVES: We aimed to assess the relationship between self-care behavior and readmission rate in patients with heart failure. PATIENTS AND METHODS: A total of 287 patients with a diagnosis of systolic CHF with a left ventricular ejection fraction less than 35% admitted for acute heart failure were enrolled. The self-care behavior was assessed using SCHFI questionnaires that have three domains (self-care maintenance, self-care management, and self-care confidence). An acquired score greater than 70 was considered as proper self-care index. The study population was followed over three months after discharge for readmission. RESULTS: This study showed that self-care behavior was improper in our study population. More than 75% of patients had a score less than 70 in the different domains for self-care. The multivariable regression analyses showed a significant relationship between self-care management (ß = 1.6, P = 0.006, OR (CI) = 2.66 (1.37-5.1) and self-care confidence (ß = 0.9, P = 0.02, OR (CI) = 2.01 (1.1-3.68) and readmission rate. CONCLUSIONS: We concluded that a good administration program such as education and a surveillance plan for the improvement of self-care behaviors would reduce hospital readmissions in patients with heart failure.

SUBMITTER: Sahebi A

PROVIDER: S-EPMC4347722 | biostudies-other | 2015 Feb

REPOSITORIES: biostudies-other

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Investigation the relationship between self-care and readmission in patients with chronic heart failure.

Sahebi Ali A Mohammad-Aliha Jaleh J Ansari-Ramandi Mohammadmostafa M Naderi Nasim N

Research in cardiovascular medicine 20150122 1

<h4>Background</h4>Chronic heart failure (CHF) is associated with unpredictably increased prevalence of hospital admissions. Self-care is one of the most important aspects of management for patients with CHF. Self-care adequacy has led to increased satisfaction, independence in daily activities, reduced stress, and morbidity.<h4>Objectives</h4>We aimed to assess the relationship between self-care behavior and readmission rate in patients with heart failure.<h4>Patients and methods</h4>A total of ...[more]

PMID: 25785253

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Project description:BackgroundPatients with heart failure frequently report inadequate self-care behaviours. Physical symptoms can impact patients' ability to perform self-care behaviours. However, studies investigating the association between physical symptoms and heart failure self-care behaviours have produced inconsistent findings, potentially due to variations in the determinants of self-care behaviours among patients with differing levels of self-care proficiency. Understanding the association between physical symptoms and self-care behaviours in heart failure patients with inadequate self-care behaviours could improve care for this subpopulation. The study aimed to explore the association between physical symptoms and self-care behaviours in Chinese heart failure patients with inadequate self-care behaviours.MethodsThis analysis was based on primary data from a cross-sectional study that aimed to investigate factors associated with self-care in heart failure patients. Physical symptoms were measured using the Heart Failure Somatic Perception Scale. Self-care behaviours (i.e., self-care maintenance and management) of heart failure were measured using the Self-Care of Heart Failure Index (version 6.2). Patients who reported scores < 70 on both self-care maintenance and management behaviours were eligible and included in the analysis. Hierarchical regression analysis was performed to explore the association between physical symptoms and self-care behaviours.ResultsA total of 189 patients were included in the analysis, with a mean age of 65 years and a median duration of living with heart failure of 24 months. Most participants were classified as New York Heart Association class III or IV. Dyspnoea symptoms were the most frequently reported physical symptoms. The results of the hierarchical regression analysis showed that the severity of physical symptoms was positively associated with self-care management behaviours (β = 0.157, 95% CI: 0.010, 0.368, p = 0.039) but not significantly associated with self-care maintenance behaviours (β = -0.133, 95% CI: -0.316, 0.026, p = 0.097).ConclusionsBased on the data collected in Changsha, China, we found that patients with HF with poor self-care experienced more dyspnoea symptoms. Severe HF physical symptoms might serve as drivers for better self-care management in patients with inadequate self-care behaviours. Effective care and support should be provided when physical symptoms worsen to facilitate patients' engagement in self-care behaviour in this subpopulation.

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Investigation the relationship between self-care and readmission in patients with chronic heart failure.

Publications

Investigation the relationship between self-care and readmission in patients with chronic heart failure.

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