Self-care behaviours and heart failure: does experience with symptoms really make a difference?

BACKGROUND: There are many reasons to explain why achievement of optimal self-care can be difficult for many patients with chronic heart failure (CHF).

AIM: To investigate differences in self-care skills between patients with and without experience of CHF symptoms.

METHODS: On the basis of a confirmed diagnosis and treatment for CHF <2 months or >2 months, patients were prospectively designated as "novices" or "experienced". Administration of the Self-Care Heart Failure Index assessed 3 self-care skills: maintenance, management and confidence. A score >70% in each scale is considered adequate self care. Hierarchal regression models were built to test three hypotheses.

RESULTS: In 143 elderly patients hospitalised with CHF, novices had lower self-care maintenance (63+/-16 vs. 71+/-14, p=0.05) and self-care management scores (48+/-17 vs. 58+/-19, p=0.003) than experienced patients. Novices were less likely to have adequate self-care maintenance (OR, 0.73; 95% CI 0.5 to 0.9, LR<0.02) and management (OR, 0.3; 95% CI, 0.1 to 0.8, p=0.02). Patients experienced with CHF had similar confidence levels (66+/-17 vs. 64+/-17, p=0.40) to novices.

CONCLUSION: Level of experience is a determinant of self-care skills suggesting this factor should be considered in determining an individual education plan.