Journal
EUROPEAN JOURNAL OF CARDIOVASCULAR NURSING
Volume 7, Issue 3, Pages 171-181Publisher
OXFORD UNIV PRESS
DOI: 10.1016/j.ejcnurse.2007.11.005
Keywords
Heart failure; Self-care; Cognition; Attitudes; Self-efficacy; Typology
Categories
Funding
- SIGMA Theta Tau International
- Johns Hopkins Bloomberg School of Public Health [T420H0087428-02]
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Background: Heart failure (HF) self-care is extremely challenging and few people master it. Self-care was defined as an active, cognitive process in which persons engage for the purpose of maintaining their health (maintenance) and managing symptoms (management). Aim: To examine the contribution of attitudes, self-efficacy, and cognition to HF self-care management. Methods: In this mixed methods study, 41 individuals (63.4% male, 68.3% Caucasian, mean age 49.17 (10.51) years, 58.5% NYHA III, median ejection fraction 30%) were interviewed and completed instruments on HF self-care, cognition, and physical functioning. Content analysis of narrative data revealed themes of self-care management practices, attitudes and self-efficacy towards self-care. Non-parametric tests assessed differences based on the types identified in the content analysis. Results: A self-care typology was constructed from the data: experts, novices and inconsistent. There were statistically significant differences (p=0.001) in self-care practices among types and variance in attitudes, self-efficacy, and cognition. Experts had experience and skill in self-care, which novices lacked, and positive attitudes and self-efficacy that aligned with their behaviors. Most patients (71%) were classified as inconsistent, a self-care type associated with impaired cognition, poor physical functioning, negative attitudes, and poor self-efficacy. Conclusions: This typology provides insight into how expertise in self-care develops and the reasons why it is not always sustained. (C) 2007 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.
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