Empowering self-management: exploring self-care practices in heart failure patients

Abstract

Purpose: Heart failure is a complex clinical syndrome in which ventricular filling and beating functions are impaired. HF also causes psychosocial and economic problems and is a significant public health problem affecting the quality of life. Effective self-care is a non-pharmacological method that contributes to treatment, improves the patient's quality of life, and reduces repeated hospitalizations and economic burdens. Our study aimed to evaluate self-care in heart failure patients and to determine the factors affecting self-care. Materials and methods: A total of 100 patients with heart failure, including 36 women and 64 men, were included in the study. Data were collected by using the Descriptive Information Form and the European Heart Failure Self-Care Behavior Scale in one-on-one interviews with patients under appropriate physical conditions. Results: Our findings indicate that a range of factors, including age, hypertension, educational status, the total number of comorbid diseases, and the use of certain medications such as SGLT-2 inhibitors, differently impact self-care behaviors. Self-care behaviors were found to be adequate in the study population. Conclusion: We identified essential factors that affect self-care in heart failure patients. We have identified critical factors such as age, educational status, hypertension, comorbidity, and particularly the use of SGLT2 inhibitors, as key influencers of self-care practices. For this reason patient-centered healthcare models should be developed and considered by medical practitioners.

Keywords

• Heart failure
• self-care behavior
• patient education
• SGLT2 inhibitors

Öz bakım yönetimini güçlendirme: kalp yetersizliği hastalarında öz bakımı etkileyen faktörlerin incelenmesi

Abstract

Amaç: Kalp yetersizliği, ventriküler dolum ve atım fonksiyonlarının bozulduğu kompleks bir klinik sendromdur. Kalp yetersizliği aynı zamanda psikososyal ve ekonomik sorunlara da yol açarak yaşam kalitesini etkileyen önemli bir halk sağlığı sorunudur. Etkili kişisel bakım, tedaviye katkı sağlayan, hastanın yaşam kalitesini artıran, tekrarlayan hastaneye yatışları ve ekonomik yükleri azaltan, farmakolojik olmayan bir yöntemdir. Çalışmamızda kalp yetersizliği hastalarında öz bakımın değerlendirilmesi ve öz bakımı etkileyen faktörlerin belirlenmesi amaçlanmaktadır. Gereç ve yöntem: Çalışmaya 36'sı kadın, 64'ü erkek olmak üzere toplam 100 kalp yetersizliği olan hasta dahil edildi. Veriler, uygun fiziksel koşullar altında hastalarla yapılan birebir görüşmelerde Tanımlayıcı Bilgi Formu ve Avrupa Kalp Yetersizliği Öz Bakım Davranış Ölçeği kullanılarak toplanmıştır. Bulgular: Bulgularımız, yaş, hipertansiyon, eğitim durumu, komorbid hastalıkların toplam sayısı ve SGLT-2 inhibitörleri gibi bazı ilaçların kullanımının öz bakım davranışlarını farklı şekillerde etkilediğini göstermektedir. Öz bakım davranışları, çalışma popülasyonunda yeterli düzeyde bulunmuştur. Sonuç: KY hastalarında öz bakımı etkileyen temel faktörleri belirledik. Yaş, eğitim durumu, hipertansiyon, komorbidite ve özellikle SGLT2 inhibitörlerinin kullanımı gibi kritik faktörleri, öz bakım uygulamalarının önemli etkileyicileri olarak belirledik. Bu nedenle, hasta merkezli sağlık bakım modelleri geliştirilmeli ve tıp uzmanları tarafından dikkate alınmalıdır.

Keywords

• Kalp yetersizliği
• öz bakım davranışı
• hasta eğitimi
• SGLT2 inhibitörleri

References

1. 1. Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology/American Heart Association joint committee on clinical practice guidelines. J Am Coll Cardiol 2022;79:1757-1780. https://doi.org/10.1016/j.jacc.2021.12.011
2. 2. Van Nuys KE, Xie Z, Tysinger B, Hlatky MA, Goldman DP. Innovation in heart failure treatment: life expectancy, disability, and health disparities. JACC Heart Fail 2018;6:401-409. https://doi.org/10.1016/j.jchf.2017.12.006
3. 3. Değertekin M. Heart failure prevalence and predictors in Turkey: HAPPY study. Turk Kardiyol Dern Ars 2012;40:298-308. https://doi.org/10.5543/tkda.2012.65031
4. 4. Oksel E, Akbıyık A, Koçak G. Kronik kalp yetmezliği olan hastalarda öz-bakım davranışlarının incelenmesi. İzmir Katip Çelebi Üniv Sağlık Bilim Fak Derg 2016;1:1-8.
5. 5. Kessing D, Denollet J, Widdershoven J, Kupper N. Self-care and health-related quality of life in chronic heart failure: a longitudinal analysis. Eur J Cardiovasc Nurs 2017;16:605-613. https://doi.org/10.1177/1474515117702021
6. 6. Köberich S, Glattacker M, Jaarsma T, Lohrmann C, Dassen T. Validity and reliability of the German version of the 9-item European Heart Failure Self-care Behaviour Scale. Eur J Cardiovasc Nurs 2013;12:150-158. https://doi.org/10.1177/1474515112438639
7. 7. Taylor SG, Mclaughlin Renpenning K. Self-care science, nursing theory and evidence-based practice. Springer Publishing Company; 2011.
8. 8. Dickstein K, Vardas PE, Auricchio A, et al. 2010 Focused update of ESC guidelines on device therapy in heart failure: an update of the 2008 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure and the 2007 ESC guidelines for cardiac and resynchronization therapy. Developed with the special contribution of the Heart Failure Association and the European Heart Rhythm Association. Eur Heart J 2010;31:2677-2687. https://doi.org/10.1093/eurheartj/ehq337

9. 9. González B, Lupón J, Herreros J, et al. Patient’s education by nurse: what we really do achieve? Eur J Cardiovasc Nurs 2005;4:107-111. https://doi.org/10.1016/j.ejcnurse.2005.03.006
10. 10. Lainscak M, Cleland JGF, Lenzen MJ, et al. Recall of lifestyle advice in patients recently hospitalised with heart failure: a EuroHeart Failure Survey analysis. Eur J Heart Fail 2007;9:1095-1103. https://doi.org/10.1016/j.ejheart.2007.08.001
11. 11. Baydemir C, Özdamar K, Ünalır A. Validity of the Turkish version of the European Heart Failure Self-care Behavior Scale. Anadolu Kardiyol Derg 2013;13:573-579. https://doi.org/10.5152/akd.2013.141
12. 12. Jaarsma T, Arestedt KF, Mårtensson J, Dracup K, Strömberg A. The European Heart Failure Self-care Behaviour scale revised into a nine-item scale (EHFScB-9): a reliable and valid international instrument. Eur J Heart Fail 2009;11:99-105. https://doi.org/10.1093/eurjhf/hfn007
13. 13. Lupón J, González B, Mas D, et al. Patients’ self-care improvement with nurse education intervention in Spain assessed by the European Heart Failure Self-Care Behaviour Scale. Eur J Cardiovasc Nurs 2008;7:16-20. https://doi.org/10.1016/j.ejcnurse.2007.05.004
14. 14. Ozer S, Karaman E, Karaoz B, Senuzun Aykar F. Validity and reliability of the Turkish version of the European Heart Failure Self-care Behaviour scale (EHFScB-9). Int J Caring Sci 2019;12:1561-1569.
15. 15. Vellone E, Jaarsma T, Strömberg A, et al. The European Heart Failure Self-care Behaviour scale: new insights into factorial structure, reliability, precision and scoring procedure. Patient Educ Couns 2014;94:97-102. https://doi.org/10.1016/j.pec.2013.09.014
16. 16. Wagenaar K, Broekhuizen B, Rutten F, et al. Interpretability of the European Heart Failure Self-care Behaviour scale. Patient Prefer Adherence 2017;26:1841-1849. https://doi.org/10.2147/PPA.S144915
17. 17. Braunwald E. Cardiovascular medicine at the turn of the millennium: triumphs, concerns, and opportunities. N Engl J Med 1997;337:1360-1369. https://doi.org/10.1056/NEJM199711063371906
18. 18. Prochota B, Szwamel K, Uchmanowicz I. Socio-clinical variables affecting the level of self-care in elderly patients with heart failure. Eur J Cardiovasc Nurs 2019;18:628-636. https://doi.org/10.1177/1474515119855600
19. 19. Rockwell JM, Riegel B. Predictors of self-care in persons with heart failure. Heart Lung 2001;30:18-25. https://doi.org/10.1067/mhl.2001.112503
20. 20. Buck HG, Dickson VV, Fida R, et al. Predictors of hospitalization and quality of life in heart failure: a model of comorbidity, self-efficacy and self-care. Int J Nurs Stud 2015;52:1714-1722. https://doi.org/10.1016/j.ijnurstu.2015.06.018
21. 21. Ausili D, Rebora P, Di Mauro S, et al. Clinical and socio-demographic determinants of self-care behaviours in patients with heart failure and diabetes mellitus: a multicentre cross-sectional study. Int J Nurs Stud 2016;63:18-27. https://doi.org/10.1016/j.ijnurstu.2016.08.006
22. 22. Warren Findlow J, Krinner LM, Vinoski Thomas E, Coffman MJ, Gordon B, Howden R. Relative and cumulative effects of hypertension self-care behaviors on blood pressure. West J Nurs Res 2020;42:157-164. https://doi.org/10.1177/0193945919851111
23. 23. Daniali SS, Eslami AA, Maracy MR, Shahabi J, Mostafavi-Darani F. The impact of educational intervention on self-care behaviors in overweight hypertensive women: a randomized control trial. ARYA Atheroscler 2017;13:20-28.
24. 24. Harkness K, Heckman G, Jewett L, McKelvie R. Self-care in heart failure index - do scores change over time? Can J Cardiol 2013;29:403-404. https://doi.org/10.1016/j.cjca.2013.07.735
25. 25. Sedlar N, Lainscak M, Farkas J. Self‐care perception and behaviour in patients with heart failure: a qualitative and quantitative study. ESC Heart Fail 2021;8:2079-2088. https://doi.org/10.1002/ehf2.13287