title: Self-care behaviours and heart failure: does experience with symptoms really make a difference?
abstract: BACKGROUND
  There are many reasons to explain why achievement of optimal self-care can be difficult for many patients with chronic heart failure (CHF).
  
  
  OBJECTIVE
  To investigate differences in self-care skills between patients with and without experience of CHF symptoms.
  
  
  METHODS
  On the basis of a confirmed diagnosis and treatment for CHF <2 months or >2 months, patients were prospectively designated as "novices" or "experienced". Administration of the Self-Care Heart Failure Index assessed 3 self-care skills: maintenance, management and confidence. A score >70% in each scale is considered adequate self care. Hierarchal regression models were built to test three hypotheses.
  
  
  RESULTS
  In 143 elderly patients hospitalised with CHF, novices had lower self-care maintenance (63+/-16 vs. 71+/-14, p=0.05) and self-care management scores (48+/-17 vs. 58+/-19, p=0.003) than experienced patients. Novices were less likely to have adequate self-care maintenance (OR, 0.73; 95% CI 0.5 to 0.9, LR<0.02) and management (OR, 0.3; 95% CI, 0.1 to 0.8, p=0.02). Patients experienced with CHF had similar confidence levels (66+/-17 vs. 64+/-17, p=0.40) to novices.
  
  
  CONCLUSIONS
  Level of experience is a determinant of self-care skills suggesting this factor should be considered in determining an individual education plan.
authors.affiliation: School of Nursing & Midwifery (Victoria), Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia. S00072101@myacu.edu.au
authors.forename: Jan
authors.initials: J
authors.lastname: Cameron
authors.forename: Linda
authors.initials: L
authors.lastname: Worrall-Carter
authors.forename: Karen
authors.initials: K
authors.lastname: Page
authors.forename: Simon
authors.initials: S
authors.lastname: Stewart
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006333:Heart Failure / Q000451:nursing* / Q000523:psychology / Q000628:therapy*; D006801:Humans; D007297:Inpatients / Q000523:psychology; D007858:Learning; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods* / Q000592:standards; D011446:Prospective Studies; D012044:Regression Analysis; D012648:Self Care / Q000379:methods* / Q000592:standards; D011795:Surveys and Questionnaires