Journal
EUROPEAN JOURNAL OF CARDIOVASCULAR NURSING
Volume 16, Issue 4, Pages 326-333Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/1474515116666439
Keywords
Heart failure; self-care; rurality
Categories
Funding
- Improving Self-Care Behavior and Outcomes in Rural Patients with Heart Failure [RO1HL083176]
- National Research Foundation of Korea - Korea government (MEST) [2016R1A2B4008495]
- National Research Foundation of Korea [2016R1A2B4008495] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)
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Background: As heart failure (HF) is a progressive, debilitating condition, life-long self-care is required to achieve good outcomes. Rural residents with HF encounter more challenges with adherence to self-care than their urban counterparts because of rural-urban inequalities related to socioeconomic resources and access to health care. To date, investigators have focused on self-care in HF patients in urban settings, although factors related to self-care may be different between rural and urban residents. Aim: The aim of this study was to explore the variables related to self-care in HF patients living in rural areas. Methods: A total of 580 patients in the USA were included in this analysis. We included 12 variables reflecting four aspects that affect patients' decisions to perform self-care: health literacy, psychosocial status, current symptom status, and aging status. We measured self-care using the European Heart Failure Self-Care Scale-9. Results: Depressive symptoms (=0.28, 95% confidence interval (CI): 0.16 to 0.45), lower perceived control (= -0.15, 95% CI: -0.32 to -0.08), better symptom status (= -0.11, 95% CI: -0.13 to -0.003), and annual income of <$20,000 (= 0.11, 95% CI: 0.38-2.97) were negatively associated with self-care in rural residents with HF. The model with 12 variables explained 7.1% of the variance in self-care. Conclusions: The variables included in the model did not sufficiently explain self-care among rural dwellers with HF. Given that all variables in the model were intrapersonal-level factors, more investigations that incorporate interpersonal factors (e.g. cultural beliefs and access to care) are needed in order to improve our understanding of self-care in HF patients living in rural areas.
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