title: Impact of provider self-management education, patient self-efficacy, and health status on patient adherence in heart failure in a Veterans Administration population.
abstract: To address the need for more information on predictors of adherence to heart failure (HF) self-management regimens, this study analyzed surveys completed by 259 HF patients receiving care at 2 Veterans Affairs hospitals in 2003. Linear multivariable regression models were used to examine general health status, HF-specific health status (Kansas City Cardiomyopathy Questionnaire) self-management education, and self-efficacy as predictors of self-reported adherence to salt intake and exercise regimens. Self-management education was provided most often for salt restriction (87%) followed by exercise (78%). In multivariable regression analyses, education about salt restriction (P=.01), weight reduction (P=.0004), self-efficacy (P=.03), and health status (P=.003) were significantly associated with patient-reported adherence to salt restriction. In a similar model, self-efficacy (P=.006) and health status (P< or = .0001), but not exercise education, were significantly associated with patient-reported exercise adherence. Findings suggest that provider interventions may lead to improved adherence with HF self-management and thus improvements in patients' health.
authors.affiliation: Roudebush VA Medical Center, Indianapolis, IN 46202, USA. usubrama@iupui.edu
authors.forename: Usha
authors.initials: U
authors.lastname: Subramanian
authors.forename: Faith
authors.initials: F
authors.lastname: Hopp
authors.forename: Allison
authors.initials: A
authors.lastname: Mitchinson
authors.forename: Julie
authors.initials: J
authors.lastname: Lowery
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006306:Health Surveys; D006333:Heart Failure / Q000188:drug therapy* / Q000628:therapy; D006801:Humans; D008019:Life Style; D008297:Male; D010349:Patient Compliance; D010353:Patient Education as Topic; D012648:Self Care; D012647:Self-Assessment; D011795:Surveys and Questionnaires; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans