title: Self-care behaviors in indigent patients with heart failure.
abstract: BACKGROUND
  Self-care has been shown to be an effective strategy to decrease heart failure (HF) costs and improve patient outcomes. However, high symptom burden, overall poor health, and economic and financial concerns in socioeconomically disadvantaged populations such as those of low socioeconomic status and those who are indigent or uninsured may have difficulty performing self-care behaviors. Currently, little is known about this group and their self-care behaviors. Therefore, the purpose of this study was to describe the demographic and clinical characteristics of indigent HF patients and their performance of self-care behaviors and explore the challenges and barriers they face in managing their HF.
  
  
  METHODS
  This was a descriptive, cross-sectional study using one-time structured interviews. Participants with HF were recruited from 3 cardiology clinics and 1 hospital. The patients were asked to answer questions regarding demographics and clinical risk factors, the Self-care of Heart Failure Index, and 3 open-ended questions regarding the challenges and barriers of managing their HF.
  
  
  RESULTS
  The sample (N = 65) was composed of 55% women, with a mean (SD) age of 59 (14), 35% were nonwhite, 86% were unemployed, and 52% were indigent. Major concerns included increasing symptoms, fear of death, lack of information, and financial challenges. Self-care was low.
  
  
  CONCLUSIONS
  Patients with low socioeconomic status and indigent HF patients face unique challenges that contribute to poor self-care. Future research is needed to explore ways to improve self-care behaviors in this population.
authors.affiliation: University of California, Los Angeles, CA 90095-6918, USA. aoconnel@sonnet.ucla.edu
authors.forename: Aurelia
authors.initials: A
authors.lastname: Macabasco-O'Connell
authors.forename: Michael H
authors.initials: MH
authors.lastname: Crawford
authors.forename: Nancy
authors.initials: N
authors.lastname: Stotts
authors.forename: Anita
authors.initials: A
authors.lastname: Stewart
authors.forename: Erika S
authors.initials: ES
authors.lastname: Froelicher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D002140:California; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008489:Medical Indigency; D008875:Middle Aged; D012648:Self Care / Q000523:psychology*; D014478:Unemployment