Abstract 2721: Engaging in Self-Care Management Improves Event-Free Survival in Adults with Heart Failure
Self-care management in heart failure (HF) involves decision-making to evaluate, and action to ameliorate symptoms when they occur. Little is known about the importance of self-care management in determining health outcomes in this population. The purpose of this study was to compare the risk of all-cause mortality, or first hospitalization or emergency room admission in HF patients who practice above average self-care management, those who practice below average self-care management, and those who are symptom-free. A retrospective analysis was completed of data collected on 195 HF patients. Self-care management was measured with the Self-Care of Heart Failure Index. The sample mean was used to categorize below and above average self-care management. A Cox proportional hazards model was used to examine the association between self-care management and event risk. The sample was elderly (61.3 ± 11 years), predominantly male (64.6%), with an average EF of 34.7% ± 15.3%; 60.1% had New York Heart Association class III or IV HF. During an average follow-up period of 364 ± 288 days, there were 4 deaths, 82 hospitalizations, and 5 emergency room visits as first events, whereas 104 subjects were event-free. Controlling for age, gender, body mass index, depressive symptoms, comorbid conditions, EF, HF etiology and medications, functional class and capacity, quality of life, and treatment adherence, those who engaged in above average self-care management had the lowest risk of an event during follow-up (HR = 0.44 (95% CI = 0.22 to 0.88), P < .05) (Image 1). Enhancing self-care management strategies should be the aim of future HF interventions.