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Multiple comorbid conditions challenge heart failure self-care by decreasing self-efficacy
Journal article   Open access   Peer reviewed

Multiple comorbid conditions challenge heart failure self-care by decreasing self-efficacy

Victoria Vaughan Dickson, Harleah Buck and Barbara Riegel
Nursing research (New York), Vol.62(1), pp.2-9
01/2013
DOI: 10.1097/NNR.0b013e31827337b3
PMID: 23052421
url
https://doi.org/10.1097/NNR.0b013e31827337b3View
Published (Version of record) Open Access

Abstract

Most heart failure patients have multiple comorbidities. This study aims to test the moderating effect of comorbidity on the relationship between self-efficacy and self-care in adults with heart failure. Secondary analysis of four mixed methods studies (n = 114) was done. Self-care and self-efficacy were measured using the Self-Care of Heart Failure Index. Comorbidity was measured with the Charlson Comorbidity Index. Parametric statistics were used to examine the relationships among self-efficacy, self-care, and the moderating influence of comorbidity. Qualitative data yielded themes about self-efficacy in self-care and explained the influence of comorbidity on self-care. Most (79%) reported two or more comorbidities. There was a significant relationship between self-care and the number of comorbidities (r = -.25; p = .03). There were significant differences in self-care by comorbidity level (self-care maintenance, F[1, 112], 5.96, p = .019, and self-care management, F[1, 72], 4.66, p = .034). Using moderator analysis of the effect of comorbidity on self-efficacy and self-care, a significant effect was found only in self-care maintenance among those who had moderate levels of comorbidity (b = .620, p = .022, F(change) df[6,48], 5.61, p = .022). In the qualitative data, self-efficacy emerged as an important variable influencing self-care by shaping how individuals prioritized and integrated multiple and often competing self-care instructions. Comorbidity influences the relationship between self-efficacy and self-care maintenance, but only when levels of comorbidity are moderately high. Methods of improving self-efficacy may improve self-care in those with multiple comorbidities.
Adult Age Factors Aged Female Health Knowledge, Attitudes, Practice Health Status Heart Failure - complications Heart Failure - psychology Heart Failure - therapy Humans Male Middle Aged Risk Factors Self Care Self Efficacy

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