Adherence to Self-Care Practices and Associated Factors Among Outpatient Adult Heart Failure Patients Attending a Cardiac Center in Addis Ababa, Ethiopia in 2020

Introduction: Proper self-care in patients with chronic illnesses, such as heart failure is allied with the prevention or early detection of health problems and improved clinical outcomes. Even though self-care among patients with heart failure is commonly poor, a low-sodium diet, regular exercise, and weight monitoring are essential to control heart failure symptoms and exacerbation. Poor adherence to these self-care practices contributes to an increase in hospitalization, morbidity, and mortality. Objective: To assess adherence to self-care practices and associated factors among outpatient adult heart failure patients attending cardiac center in Ethiopia, Addis Ababa, 2020. Methods: Institution-based cross-sectional study design was used to incorporate 396 heart failure patients who attended the cardiac center in Ethiopia, Addis Ababa. The study was conducted from March to April 2020. Study participants were selected by using a systematic sampling technique. Data were collected through face-to-face interviews and from the patients' medical records. Epi-data version 3.1 and SPSS version 26 were used for data entry and analysis, respectively. Binary logistic regression analysis was performed to identify predictors of self-care practice. Those variables with p-value <0.25 in the bivariable regression analysis were entered into the multivariable regression analysis and the result were presented using tables, chart, and mean. Results: Of 396 respondents, 111 (28%) of patients with heart failure had overall good self-care adherence. Comorbidity (AOR: 1.62; 95% CI: 1.07-2.624), level of knowledge (AOR: 3.58; 95% CI: 2.23-5.79) and depression (AOR: 2.45; 95% CI: 1.048-5.726) were factors significantly associated with adherence to self-care practice. Conclusion: Comorbidity, inadequate knowledge, and depression were predictors of self-care practice. As a result, nursing intervention programs regarding knowledge on heart failure are recommended for enhancing self-care practices. Self-care strategies shall target patients with depression and comorbidity.

Automated summary

The study assessed self-care adherence among outpatient adult heart failure patients in 2020 at the cardiac center in Addis Ababa, Ethiopia. Results showed that comorbidity, level of knowledge, and depression were significantly associated with adherence to self-care practice among heart failure patients. Recommendations include nursing intervention programs to improve knowledge on heart failure and targeting self-care strategies towards patients with depression and comorbidity.