Abstract 17863: Self-Efficacy Moderates the Relationship of Comorbidity and Self-Care in Heart Failure Patients
Most heart failure (HF) patients have comorbid conditions that necessitate adherence to multiple treatment regimens and management of overlapping symptoms. The complexity of dealing with HF plus other comorbid conditions complicates the process of self-care. Self-efficacy has been shown to be important in self-care. We hypothesized that self-efficacy moderates the relationship between comorbidity and self-care in adults with HF.
Methods: A sample of 280 adults with HF (34% black, 36% female, mean age 62±12.5 years) was enrolled into a longitudinal descriptive study. The moderation analysis was conducted using baseline data. Self-care, defined as a process of self-care maintenance (symptom monitoring and treatment adherence) and self-care management (management of symptoms) was measured using the Self-Care of Heart Failure Index (SCHFI V6.2) as was self-care self-efficacy or confidence. Scores on each scale range from 0-100; higher scores are better, a score ≥70 is considered adequate. Comorbidity was measured as the total number of chronic conditions obtained from review of the medical record.
Results: Self-care maintenance (mean 66.8±11.9) and self-care management (67.4±18.6) were adequate in 48% and 50% of the sample, respectively. Self-care confidence was high (mean 75.8±14.4). Most (60%) had 3 or more comorbidities (mean 3.3±2.1). There was a significant relationship between the number of comorbid conditions, self-care maintenance, self-care management and self-care confidence (all p<.001). Using moderator analysis of the interaction of self-efficacy and comorbidity on self-care, controlling for age and gender, there was a significant moderating effect of self-efficacy on both self-care maintenance (b=.217, p<.001) and self-care management (b=.202, p<.001).
Conclusion: The hypothesis that self-efficacy moderates the relationship between comorbidity and self-care was supported. These results suggest that self-care interventions focused on increasing self-efficacy may be especially beneficial for the majority of HF patients who have multiple comorbid conditions.
- © 2013 by American Heart Association, Inc.