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Trajectories of heart failure self-care management and changes in quality of life.
- Source :
- European Journal of Cardiovascular Nursing; Dec2015, Vol. 14 Issue 6, p486-494, 9p
- Publication Year :
- 2015
-
Abstract
- Introduction: Heart failure patients vary considerably in their self-care management behaviors (i.e. recognizing and responding to symptoms). The goal of this study was to identify unique patterns of change in heart failure self-care management and quantify associations between self-care management and quality of life (HRQOL) over time. Methods: A prospective cohort study among adults with symptomatic heart failure was designed to measure changes in self-care management (Self-care of Heart Failure Index) and HRQOL (Kansas City Cardiomyopathy Questionnaire) over six months. Growth mixture modeling was used to identify unique trajectories of change in self-care management. Results: The mean age (n=146) was 57 years, 70% were male, and 41% had class II heart failure. Two trajectories of self-care management were identified (entropy = 0.88). The larger trajectory (73.3%) was characterized by a significant decline in self-care management over time and no change in HRQOL. The smaller trajectory (26.7%) was characterized by marked improvements in self-care management and HRQOL. Changes in heart failure self-care management occurred in the absence of change in routine self-care maintenance behaviors, functional classification, and physical and psychological symptoms. Patients with greater physical symptoms at enrollment (odds ratio (OR) =1.04, p=0.037), larger left ventricles (OR=1.50, p=0.044), and ischemic heart failure (OR=3.84, p=0.014) were more likely to have the declining trajectory of self-care management. Higher levels of depression at enrollment were associated with reduced odds of having a decline in self-care management over time (OR=0.85, p<0.001). Conclusions: There are unique and clinically-relevant trajectories of change in heart failure self-care management that are associated with differences in HRQOL. [ABSTRACT FROM AUTHOR]
- Subjects :
- HEART failure treatment
HEART failure
CHI-squared test
CONCEPTUAL structures
CONFIDENCE intervals
LONGITUDINAL method
MULTIVARIATE analysis
QUALITY of life
QUESTIONNAIRES
RESEARCH funding
SCALE analysis (Psychology)
HEALTH self-care
T-test (Statistics)
LOGISTIC regression analysis
EFFECT sizes (Statistics)
DATA analysis software
ODDS ratio
PSYCHOLOGY
Subjects
Details
- Language :
- English
- ISSN :
- 14745151
- Volume :
- 14
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- European Journal of Cardiovascular Nursing
- Publication Type :
- Academic Journal
- Accession number :
- 110940479
- Full Text :
- https://doi.org/10.1177/1474515114541730