Journal
HEART & LUNG
Volume 40, Issue 1, Pages 12-20Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.hrtlng.2009.12.003
Keywords
Heart failure; Self-care; Adherence; Self-management; Survival
Funding
- U.S. National Institute of Nursing Research [F31NR010299, R01 NR007952, R01 NR009280]
- American Association of Critical Care Nurses
- NATIONAL INSTITUTE OF NURSING RESEARCH [F31NR010299, R01NR007952, R01NR009280] Funding Source: NIH RePORTER
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BACKGROUND: Self-care management in heart failure (HF) involves decision-making to evaluate, and actions to ameliorate symptoms when they occur. This study sought to compare the risks of all-cause mortality, hospitalization, or emergency-room admission among HF patients who practice above-average self-care management, those who practice below-average self-care management, and those who are symptom-free. METHODS: A secondary analysis was conducted of data collected on 195 HF patients. A Cox proportional hazards model was used to examine the association between self-care management and event risk. RESULTS: The sample consisted of older (mean +/- standard deviation = 61.3 +/- 11 years), predominantly male (64.6%) adults, with an ejection fraction of 34.7% +/- 15.3%; 60.1% fell within New York Heart Association class III or IV HF. During an average follow-up of 364 288 days, 4 deaths, 82 hospitalizations, and 5 emergency-room visits occurred as first events. Controlling for 15 common confounders, those who engaged in above-average self-care management (hazard ratio,.44; 95% confidence interval, .22 to .88; P < .05) and those who were symptom-free (hazard ratio, 0.48; 95% confidence interval, .24 to .97; P < .05) ran a lower risk of an event during follow-up than those engaged in below-average self-care management. CONCLUSION: Symptomatic HF patients who practice above-average self-care management have an event-free survival benefit similar to that of symptom-free HF patients.
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