Predictors of Successful Heart Failure Self-Care Maintenance in the First Three Months after Hospitalization

Objective The objective of this study was to replicate a prior study of predictors of self-care in heart failure (HF). Design A non-experimental, correlational replication study retested a model of 7 variables: social support, symptom severity, comorbidity, education, age, gender, and income; the last variable, income, was tested in the prior study but was excluded in this study because of missing data. The model was tested at baseline and 3 months after hospitalization. Setting Participants were enrolled from 2 hospitals in southern California. Patients A convenience sample of 66 patients with chronic HF were studied. The sample was elderly, primarily female, and educated at the high school level or above. Approximately half of the patients had systolic HF, and most were functionally compromised. Outcome measure Self-care maintenance, a component of self-care, was measured with the maintenance subscale of the Self-Care of Heart Failure Index. Results At baseline, the model was significant (F = 2.61, df = 7,58, P = .02) and explained 14.8% of the variance in HF self-care. Significant predictors of self-care were higher age and male gender. Three months later, when baseline self-care maintenance scores were controlled in the analysis, the model explained 45.3% of the variance in HF self-care. Most of the variance was explained by the baseline self-care score, but male gender and low comorbidity added an additional 6% of the variance (F = 6.9, df = 9,56, P < .0001). Conclusions Elderly men and those with fewer comorbid illnesses were most successful at HF self-care.