A typology of heart failure self-care management in non-elders.
BACKGROUND
Heart failure (HF) self-care is extremely challenging and few people master it. Self-care was defined as an active, cognitive process in which persons engage for the purpose of maintaining their health (maintenance) and managing symptoms (management).


OBJECTIVE
To examine the contribution of attitudes, self-efficacy, and cognition to HF self-care management.


METHODS
In this mixed methods study, 41 individuals (63.4% male, 68.3% Caucasian, mean age 49.17 (10.51) years, 58.5% NYHA III, median ejection fraction 30%) were interviewed and completed instruments on HF self-care, cognition, and physical functioning. Content analysis of narrative data revealed themes of self-care management practices, attitudes and self-efficacy towards self-care. Non-parametric tests assessed differences based on the types identified in the content analysis.


RESULTS
A self-care typology was constructed from the data: experts, novices and inconsistent. There were statistically significant differences (p=0.001) in self-care practices among types and variance in attitudes, self-efficacy, and cognition. Experts had experience and skill in self-care, which novices lacked, and positive attitudes and self-efficacy that aligned with their behaviors. Most patients (71%) were classified as inconsistent, a self-care type associated with impaired cognition, poor physical functioning, negative attitudes, and poor self-efficacy.


CONCLUSIONS
This typology provides insight into how expertise in self-care develops and the reasons why it is not always sustained.
Dickson
Victoria Vaughan
VV
School of Nursing, University of Pennsylvania, Philadelphia, PA 19104-6096, United States. vdickson@nursing.upenn.edu
Deatrick
Janet A
JA
Riegel
Barbara
B
D000328:Adult; D003657:Decision Making; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008297:Male; D016743:Mental Competency; D008875:Middle Aged; D008960:Models, Psychological; D010349:Patient Compliance; D012648:Self Care / Q000145:classification / Q000523:psychology; D020377:Self Efficacy; D014481:United States