Abstract 2722: Poor Heart Failure Self-Care is a Worldwide Problem
Heart failure (HF) is reaching epidemic proportions across the world. Self-care, an integral component of therapy, is known to be poor in the US but little is known about self-care in other populations. In a descriptive, comparative study, 6 samples (2,082 adults) were drawn from 4 ethnically/culturally diverse locations in Australia, Thailand, and the US (blacks and whites in the northeast; Hispanics from the southwest). All investigators used the same general inclusion and exclusion criteria. All patients had a diagnosis of chronic HF objectively confirmed and all resided in a private residence where self-care was a reasonable expectation. Self-care was measured using carefully translated versions of the Self-Care of HF Index (SCHFI), which provided scores on self-care maintenance, management, and confidence. Data were integrated and analyzed using multivariate analysis after demographic (education), clinical (NYHA, newness of diagnosis), and treatment (participation in disease management) differences were controlled. When adequate self-care was defined as a standardized score ≥70%, self-care was inadequate in most categories in most groups (Figure⇓). After adjusting mean scores with covariates, group differences were still evident, with self-care maintenance lowest in the Thai and Hispanic samples (p<.001), management and confidence lowest in the Thai sample (p< .001), and confidence highest in the Hispanic sample (p<.001). Self-care was poor in all of the samples. Intervention studies aimed at improving self-care are greatly needed in all the countries studied.