Factors Associated with Heart Failure Knowledge and Adherence to Self-Care Behaviors in Hospitalized Patients with Acute Decompensated Heart Failure Based on Data from 'the Weak Heart' Educational Program

Jolanta Kolasa,1 Magdalena Lisiak,2 Marcin Grabowski,3 Ewa A Jankowska,4 Malgorzata Lelonek,5 Jadwiga Nessler,6 Agnieszka Pawlak,7 Izabella Uchmanowicz2 1Medical Unit Cardiology, Novartis Poland Sp. z o.o, Warsaw, Poland; 2Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland, and Centre for Heart Diseases, University Hospital, Wroclaw, Poland; 3 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland; 4Centre for Heart Diseases, University Hospital, Wroclaw, Poland, and Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland; 5Department of Noninvasive Cardiology, Medical University of Lodz, Lodz, Poland; 6Department of Coronary Disease and Heart Failure, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland; 7Department of Invasive Cardiology, Centre of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland, and Department of Applied Physiology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, PolandCorrespondence: Jolanta KolasaMedical Unit Cardiology, Novartis Poland Sp. z o.o, Marynarska 15, Warsaw, 02-674, PolandTel +48 22 375 48 88Email jolanta.kolasa@novartis.comPurpose: As insufficient adherence to recommendations is a major cause of poor health outcomes in patients with heart failure (HF), it is important to identify the factors that improve disease knowledge and self-care behaviors. We aimed to identify factors associated with HF knowledge and self-care behaviors in patients hospitalized due to acute decompensated heart failure (ADHF) in Poland.Patients and Methods: This was a secondary analysis of data from a multi-center, prospective, non-randomized educational program named “The Weak Heart”, which was conducted in 14 cardiology centers in Poland. The level of HF knowledge was assessed using a questionnaire developed by the research team, and self-care behaviors were evaluated using the European Heart Failure Self-care Behaviour Scale (9-EHFScBS) questionnaire.Results: The study included 259 patients admitted to the hospital with ADHF. The mean HF knowledge and 9-EHFScBS questionnaire scores were 8.25± 4.34 and 25.2± 9.5, respectively. The patients’ level of education (P = 0.002), number of prior HF hospitalizations (P = 0.008), and previous disease education (P < 0.001) were independently associated with better HF knowledge. Age (P = 0.03) and disease education (P = 0.02) were independently associated with self-care behaviors.Conclusion: The adherence to self-care recommendations among patients with ADHF is insufficient. Disease education positively influenced both HF knowledge and self-care abilities. To improve patients’ adherence to HF recommendations, well-designed models of education based on HF management guidelines should be implemented.Keywords: adherence, heart failure, health education, self-care behaviors