title: Predictors of modifications in instrumental activities of daily living in persons with heart failure.
abstract: OBJECTIVE
  The objective of this study was to identify factors related to disability in heart failure (HF) patients using a modified version of the model of disability proposed by Nagi. The hypothesized relationships among pathology (severity of HF and comorbidity), impairment (dyspnea, fatigue, muscle strength), functional limitation (functional capacity), and disability (modification in instrumental activities of daily living [IADLs]) were assessed as well as the influence of age and sex on pathways to disability.
  
  
  RESULTS
  Using a cross-sectional design, a convenience sample of 48 men and 53 women (mean age, 59.5 years) with New York Heart Association class II-IV was recruited at a HF clinic. Path analyses via Amos revealed that 71% of the variance in modifications in IADLs was explained by the significant predictors of dyspnea (B = .67), functional capacity (B = -.25), and age (B = .19). Dyspnea and comorbidity also had indirect effects on modification in IADLs through functional capacity. Age also had an indirect effect on modification in activities of daily living through functional capacity, and sex had an indirect effect through dyspnea and functional capacity.
  
  
  CONCLUSIONS
  Patients with HF may benefit from interventions targeted at reducing dyspnea with daily activities and improving functional capacity to prevent disability.
authors.affiliation: University of Nebraska Medical Center College of Nursing, Omaha, Nebraska 68198-5330, USA. yaewonseo@unmc.edu
authors.forename: Yaewon
authors.initials: Y
authors.lastname: Seo
authors.forename: Beverly L
authors.initials: BL
authors.lastname: Roberts
authors.forename: Louise
authors.initials: L
authors.lastname: LaFramboise
authors.forename: Bernice C
authors.initials: BC
authors.lastname: Yates
authors.forename: Justin M
authors.initials: JM
authors.lastname: Yurkovich
mesh_terms: D000203:Activities of Daily Living; D018493:Cardiovascular Deconditioning; D015897:Comorbidity; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D018450:Disease Progression; D004417:Dyspnea / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000453:epidemiology / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D053580:Muscle Strength