Educational needs for improving self-care in heart failure patients with diabetes.
To explore the need for self-monitoring and self-care education in heart failure patients with diabetes (HF- DM patients) by describing cognitive and affective factors to provide guidance in developing effective self-management education.



A cross-sectional correlation design was employed using baseline patient data from a study testing a 12-week patient and family dyad intervention to improve dietary and medication-taking self-management behaviors in HF patients. Data from 116 participants recruited from metropolitan Atlanta area were used. Demographic and comorbidities, physical function, psychological distress, relationship with health care provider, self-efficacy (medication taking and low sodium diet), and behavioral outcomes (medications, dietary habits) were assessed. Descriptive statistics and a series of chi-square tests, t tests, or Mann-Whitney tests were performed to compare HF patients with and without DM.



HF-DM patients were older and heavier, had more comorbidities, and took more daily medications than HF patients. High self-efficacy on medication and low-sodium diet was reported in both groups with no significant difference. Although HF-DM patients took more daily medications than HF, both groups exhibited high HF medication-taking behaviors. The HF-DM patients consumed significantly lower total sugar than HF patients but clinically higher levels of sodium.



Diabetes educators need to be aware of potential conflicts of treatment regimens to manage 2 chronic diseases. Special and integrated diabetes self-management education programs that incorporate principles of HF self-management should be developed to improve self-management behavior in HF-DM patients.
Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia (Dr Cha, Dr Reilly, Dr Higgins, Dr Lobb, Dr Dunbar)
EunSeok
E
Cha
Byrdine F. Lewis School of Nursing & Health Professions, Georgia State University, Atlanta, Georgia (Dr Clark)
Patricia C
PC
Clark
Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia (Dr Cha, Dr Reilly, Dr Higgins, Dr Lobb, Dr Dunbar)
Carolyn Miller
CM
Reilly
Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia (Dr Cha, Dr Reilly, Dr Higgins, Dr Lobb, Dr Dunbar)
Melinda
M
Higgins
Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia (Dr Cha, Dr Reilly, Dr Higgins, Dr Lobb, Dr Dunbar)
Maureen
M
Lobb
School of Medicine, Emory University, Atlanta, Georgia (Dr Smith)
Andrew L
AL
Smith
Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia (Dr Cha, Dr Reilly, Dr Higgins, Dr Lobb, Dr Dunbar)
Sandra B
SB
Dunbar
D000328:Adult; D000368:Aged; D001786:Blood Glucose; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000628:therapy; D004032:Diet; D005260:Female; D015438:Health Behavior; D006301:Health Services Needs and Demand; D006333:Heart Failure / Q000150:complications* / Q000628:therapy; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010353:Patient Education as Topic; D012648:Self Care / Q000592:standards*
D001786:Blood Glucose