Interplay between psychosocial and heart failure related factors may partially explain limitations in self-efficacy in patients with heart failure: Insights from a real-world cohort of 1,123 patients.

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Publisher: Elsevier B.V.
Document Type: Report
Length: 606 words

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Keywords Heart failure; Self-care; Heart failure nursing; Psychosocial factors; Scale Abstract Background and aims Worse self-care is associated with a higher risk of readmission and mortality in patients with heart failure (HF). Little is known about how the interplay between clinical and psycho-social factors may modulate self-care behaviours in these patients. The aim of our study was to identify clinical, and particularly psycho-social factors associated with worse self-care and assess their interaction inpatients with heart failure. Methods and results We conducted an observational, prospective, cohort study of 1,123 consecutive patients with chronic heart failure. Self-care was assessed with the modified European Heart Failure Self-care Behavior Scale 9-item version (EHFSCBS-9), and both clinical and psycho-social profile of the patients included were also meticulously evaluated. A total of 484 patients (43%) were women, mean age was 72 years, and mean left ventricular ejection fraction was 44.5%. In multivariable analyses combining clinical and psycho-social factors, low social support (OR 3.53, 95% CI [2.13-5.86]; p-value Conclusion Impairment in self-care behaviour is strongly determined by psycho-social factors. Specifically, low social support, the lack of caregiver support and the presence of depressive symptoms are the main drivers of the risk of impairment of self-care in heart failure patients. Evaluation of self-care and self-care interventions should be complemented by a comprehensive psycho-social assessment in patients with heart failure. Abbreviations DAMOCLES, Definition of the neuro-hormonal Activation, Myocardial function, genOmic expressionand CLinical outcomes in hEart failure patients; NYHA, New York Heart Failure Association; GAM, Generalized Additive Model; BMI, Body Mass Index; GDS, GeriatricDepression Scale. Author Affiliation: (a) Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain (b) Community Heart Failure Program, Cardiology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain (c) Cardiology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain (d) Advanced Heart Failure and Heart Transplantation Unit, Cardiology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain (e) Primary Care Service Litoral, Barcelona, Spain (f) Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain (g) Department of Community Nursing, Preventive Medicine, Public Health and History of Science. Faculty of Health Sciences. University of Alicante. Alicante. Spain (h) Department of Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain (i) Head of Advanced Practice Nurses, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain (j) Biomedical Research in Heart Diseases. IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain (k) Escuela Superior de Enfermería del Mar, Parc de Salut Mar, Barcelona, Spain (l) Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain (m) Primary Care Service Delta del Llobregat, Barcelona, Spain * Corresponding author at: Community Heart Failure Program, Cardiology Department, Bellvitge University Hospital, Feixa Llarga, s/n, 08907 L' Hospitalet de Llobregat, Barcelona, Spain. Article History: Received 27 July 2021; Revised 7 March 2022; Accepted 8 March 2022 Byline: E. Calero-Molina (a,b,c,d,g), P. Moliner [pmoliner@bellvitgehospital.cat] (a,b,c,d,g,*), E. Hidalgo (b,c,d,g), L. Rosenfeld (c,d,e,g), J.M. Verdú-Rotellar (e,f,d,g), J. Verdú-Soriano (j,d,g), S. Yun (a,b,g,h,d), A. Garay (a,b,c,d,g), L. Alcoberro (b,c,d,g), S. Jiménez-Marrero (a,b,c,d,g), N. Jose (b,d,g), E Calvo (c,d,g), M. Ruiz (b,d,g), P. Garcimartin (i,j,k,d,g), A. Alcaide-Aldeano (l,d,g), C. Delso (m,d,g), L. Alcober (m,d,g), C. Enjuanes (a,b,c,d,g), J. Comin-Colet [jcomin@bellvitgehospital.cat] (a,b,c,d,g,l,**)

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Gale Document Number: GALE|A700885980