[Self-care behavior and patients' knowledge about self-care predict rehospitalization among older adults with heart failure].
BACKGROUND
This study examined the association of self-care behavior and patients' knowledge about self-care with rehospitalization among older adults with heart failure (HF).


METHODS
Case-control comparison (116 cases and 209 controls) nested in a prospective cohort of patients aged 65 years and older admitted for HF at 4 Spanish hospitals. Cases were patients experiencing a first emergency rehospitalization in the 6 months following the index hospital admission. Controls were patients who did not undergo a rehospitalization during such time-period.


RESULTS
The number of self-care behaviors was inversely associated with the frequency of readmission (p for linear trend: 0.006). Compared with patients showing the appropriate self-care behavior, hospital readmission was more frequent among those who did no go for a walk daily or did not engage in any daily physical activity (hazard ratio [HR] 1.55; 95% confidence limits [CL] 1.04-2.29), and among those who did not keep their medical appointments (HR 1.82; 95% CL 1.10-3.02). Hospital readmission was also more frequent among patients who: failed to take their medication at the scheduled time (HR 2.07; 95% CL 1.15-3.72); stopped taking their medication when it disagreed with them (HR 1.76; 95% CL 1.08-2.85); and failed to adhere to their drug treatment (HR 1.96; 95% CL 1.29-2.98). Furthermore, the fewer the number of behaviors which patients knew to be required for self-care, the greater the frequency of rehospitalization (p for linear trend:0.029).


CONCLUSIONS
A lower degree of self-care and of patients' knowledge about self-care predicted a higher risk of hospital readmission.
Rodríguez Artalejo
F
F
Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, España. fernando.artalejo@uam.es
Guallar-Castillón
P
P
Montoto Otero
C
C
Conde Herrera
M
M
Carreño Ochoa
C
C
Tabuenca Martín
A I
AI
Olcoz Chiva
M
M
Conthe
P
P
Banegas
J R
JR
Rodríguez Pascual
C
C
D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011379:Prognosis; D011446:Prospective Studies; D012648:Self Care