Abstract 1730: A Typology of Heart Failure Self-Care Management
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). The purpose of this study was 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% Non-Hispanic white, mean age 49.17 (10.51) years, 58.5% NYHA III, median ejection fraction 30%) participated in one semi-structured interview and completed valid instruments on HF self-care, cognition and physical functioning. Content analysis of narrative data from the interviews was used to identify themes of self-care management practices, attitudes and self-efficacy towards self-care. Non-parametric tests were used to assess 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 and positive attitudes and self-efficacy that aligned with their behaviors. Novices lacked experience, skill and self-efficacy. 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 reasons why it is not always sustained. Tailored interventions targeting attitudes, self-efficacy, and cognition are needed for patients characterized as Expert, Novice, or Inconsistent in HF self-care.