Self-care Moderates the Relationship Between Symptoms and Health-Related Quality of Life in Heart Failure.
Jonathan P Auld, James O Mudd, Jill M Gelow and 2 others
PMID 28930784WHAT IT FOUND
In adults with heart failure, the link between symptoms and quality of life was different at different levels of self-care.
High self-care was associated with better emotional quality of life when symptoms were severe, but worse when symptoms were mild.
Key findings
01Self-care was associated with different links between physical heart failure symptoms and emotional quality of life. Higher self-care was associated with better emotional quality of life when symptoms were severe, but worse emotional quality of life when symptoms were mild.
02Self-care maintenance, but not management, was associated with a different link between depression and physical quality of life. Poor maintenance with more severe depression was associated with worse physical quality of life.
03Better self-care maintenance and management were independently associated with worse emotional and physical quality of life in adjusted models, while worse physical symptoms and more severe depression were independently associated with worse quality of life.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study measured symptoms, self-care, and quality of life at one time, so it cannot show that self-care caused better or worse quality of life. It was conducted at one advanced heart failure clinic in the United States, and the authors note the patients may be younger, sicker, and more likely to have non-ischemic heart failure than other heart failure populations. The moderation effects were small, accounting for about 1 to 2% of the variance in quality of life, so self-care was only a small part of the symptom-quality-of-life relationship. The analysis excluded people with major cognitive disorders, heart transplant or ventricular-assist device, and people unable to complete study requirements, so it may not apply to those groups.
Declared interests
The supplied text notes NIH extramural research support. It does not include a conflict-of-interest declaration.
The easy way to misread this
Do not read these results as proof that teaching self-care improves heart failure quality of life. This was a cross-sectional study, and high self-care was associated with worse emotional quality of life when physical symptoms were mild.