Heart Failure Rehospitalization and Delayed Decision Making: The Impact of Self-care and Depression.
Jiayun Xu, Joseph J Gallo, Jennifer Wenzel and 10 others
PMID 28574972WHAT IT FOUND
Self-care management showed no clear link to 30-day heart failure rehospitalization.
High depressive symptoms were linked to delayed hospital decisions and 30-day rehospitalization. Shortness of breath was linked to quicker help-seeking.
Key findings
01High HF self-care management was associated with 53% lower odds of 30-day rehospitalization, but the result did not reach statistical significance.
02High depressive symptoms were significantly associated with 5.3 times higher odds of delayed decision making, and 30-day rehospitalization odds were 2.3 times higher among those with high depressive symptoms.
03Shortness of breath was significantly associated with 80% lower odds of delayed decision making.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was small and came from one urban East Coast teaching hospital. Rehospitalization, decision delay, and several medical variables were self-reported, and charts were incomplete because patients moved between health systems. The study could not tell whether waiting to go to hospital was clinically appropriate or harmful. Four survey participants had missing data that were imputed. The authors said the small survey sample may have increased the likelihood of a Type 1 error. The qualitative sample was purposive and small, with 15 participants and only 13 interviews audio recorded.
Declared interests
No conflicts of interest were reported. No funding source was stated in the supplied text.
The easy way to misread this
Do not conclude that treatment for depression or better self-care scores will prevent rehospitalization. This was a cross-sectional survey and interview study, not a test of treatment. The self-care management association was not statistically significant.