Patterns of heart failure symptoms are associated with self-care behaviors over 6 months.
Jonathan P Auld, James O Mudd, Jill M Gelow and 3 others
PMID 29442523WHAT IT FOUND
Sustained high heart failure symptoms were associated with higher self-care maintenance and management over 6 months; sustained low symptoms were associated with persistently lower self-care.
Key findings
01Sustained high heart failure symptoms were associated with higher self-care maintenance and management over 6 months, while sustained low symptoms were associated with persistently lower self-care.
02Self-care management was inadequate (<70 on a 0-100 scale) at baseline and did not improve significantly over 6 months, while self-care maintenance was adequate (>70) and stable.
03Female sex and higher depressive symptoms were associated with high-symptom group membership, while ACE inhibitor or ARB prescription was associated with reduced likelihood of high-symptom group membership.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was an observational analysis, not a treatment study, so it cannot show that symptoms caused self-care or that self-care changed symptoms. Participants were assessed only at enrollment, 3 months and 6 months, so changes between visits or non-linear patterns could have been missed. The analysis used secondary data from an earlier study, so variables not collected originally could not be included. The high-symptom group was small (16%, n=24), which may have limited the ability to detect smaller effects. The sample averaged 57 years, was 30% women, 86% self-identified Caucasian, and 64% had non-ischemic cardiomyopathy, so findings may not generalise to older, more diverse or ischemic heart failure populations.
Declared interests
The authors declared no conflict of interest. Publication types indicate NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not conclude that this study shows a self-care intervention improves outcomes. It observed symptom and self-care patterns over 6 months; it did not test an intervention or measure outcomes.