title: Self-care confidence mediates the relationship between perceived social support and self-care maintenance in adults with heart failure.
abstract: BACKGROUND
  Social support may be associated with heart failure (HF) self-care; however, the mechanisms are not well understood. We examined the association between perceived support and self-care behaviors and whether self-care confidence mediates these relationships.
  
  
  METHODS
  Cross-sectional survey of HF patients seen in outpatient clinic settings. Our outcome (HF self-care maintenance and self-care management) and mediator (HF self-care confidence) variables were assessed with the Self-Care of Heart Failure Index. Perceived emotional/informational support was assessed with the Medical Outcomes Study social support survey. We performed regression analyses to examine associations between perceived support and HF self-care behaviors. Mediation analysis was performed according to the Baron and Kenny method.
  
  
  RESULTS
  We surveyed 150 HF patients (mean age 61 y; 51% female; 43% black). More emotional/informational support was associated with better self-care maintenance (β = 0.13; P = .04). More emotional/information support was associated with better self-care management in unadjusted (β = 0.23; P = .04), but not adjusted (β = 0.20, P = .10), analysis. Self-care confidence mediates the association between perceived support and self-care maintenance (percent change in β coefficient was 32%) and management (percent change in β coefficient was 20%).
  
  
  CONCLUSIONS
  Perceived emotional/informational support is associated with better self-care maintenance and possibly better self-care management. Greater self-care confidence is one mediating mechanism.
authors.affiliation: Division of General Internal Medicine, University of North Carolina, Chapel Hill, NC 27599, USA. ccene@med.unc.edu
authors.forename: Crystal W
authors.initials: CW
authors.lastname: Cené
authors.forename: Laura Beth
authors.initials: LB
authors.lastname: Haymore
authors.forename: Diane
authors.initials: D
authors.lastname: Dolan-Soto
authors.forename: Feng-Chang
authors.initials: FC
authors.lastname: Lin
authors.forename: Michael
authors.initials: M
authors.lastname: Pignone
authors.forename: Darren A
authors.initials: DA
authors.lastname: Dewalt
authors.forename: Jia-Rong
authors.initials: JR
authors.lastname: Wu
authors.forename: Christine Delong
authors.initials: CD
authors.lastname: Jones
authors.forename: Giselle
authors.initials: G
authors.lastname: Corbie-Smith
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006333:Heart Failure / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012648:Self Care / Q000379:methods* / Q000523:psychology*; D012649:Self Concept; D012944:Social Support