Trajectory of self-care behaviour in patients with heart failure: the impact on clinical outcomes and influencing factors.
Maria Liljeroos, Naoko P Kato, Martje Hl van der Wal and 5 others
PMID 31992064WHAT IT FOUND
Patients whose heart failure self-care declined over 12 months had a nine-times higher risk of cardiovascular hospitalisation than those who maintained good self-care.
Consistently poor self-care was not significantly linked to higher hospitalisation rates after correction for multiple comparisons.
Key findings
01Patients with decreasing self-care behaviour had a nine-times higher risk of hospitalisation for cardiovascular reasons compared to patients with persistently good self-care behaviour.
02Patients with consistently poor self-care behaviour did not have significantly higher rates of cardiovascular hospitalisation compared to the reference group after Bonferroni correction.
03Depressive symptoms and low perceived control were significantly related to poor or decreased self-care behaviour.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study excluded patients who died or were lost to follow-up, which may bias results toward healthier survivors. Patients who did not respond to questionnaires were classified as having poor self-care, which may misclassify some patients. The sample consisted of clinically stable patients with systolic dysfunction, limiting generalisability to those with preserved ejection fraction or more severe disease. The study was a secondary analysis of a randomised trial, and the original randomisation did not influence the self-care trajectory groups, so causal links between follow-up models and self-care changes are not established.
Declared interests
The authors declared no conflicts of interest. The study was funded by the Netherlands Heart Foundation.
The easy way to misread this
Do not assume that patients with consistently poor self-care have the same hospitalisation risk as those whose self-care declines. The study found a significant nine-fold increase in cardiovascular hospitalisation risk only for patients whose self-care worsened over time. Patients who remained consistently poor did not show a statistically significant increase in risk after correction for multiple comparisons.