title: Structural equation model testing the situation-specific theory of heart failure self-care.
abstract: OBJECTIVE
  To test the situation-specific theory of heart failure self-care with structural equation modelling.
  
  
  BACKGROUND
  Several authors have proposed theories on heart failure self-care, but only the situation-specific theory of heart failure self-care by Riegel and Dickson is focused on the process that patients use to perform self-care. This theory has never been tested with structural equation modelling.
  
  
  METHODS
  A secondary analysis of data from a cross-sectional study.
  
  
  METHODS
  Patients with heart failure were recruited in 21 cardiovascular centres across Italy during 2011. Data were collected with a sociodemographic questionnaire, chart abstraction for clinical data and the Self-Care of Heart Failure Index v.6.2.
  
  
  RESULTS
  A sample of 417 participants was enrolled in the study (59% males, mean age 72 years). The following propositions were tested and supported: Symptom monitoring correlates with treatment adherence; symptom monitoring and treatment adherence have a direct, positive relationship with symptom recognition and evaluation that in turn have a direct, positive relationship with treatment implementation; treatment implementation has a direct, positive relationship with treatment evaluation. In addition, the following three relationships were found: Symptom monitoring has a direct, positive relationship with treatment implementation; symptom recognition and evaluation have direct, positive relationships with treatment evaluation and symptom monitoring correlates with treatment evaluation. [Correction added on 9th April 2013, after first online publication: '…symptom monitoring correlates with treatment implementation.' has been corrected to read '…symptom monitoring correlates with treatment evaluation.']
  
  
  CONCLUSIONS
  The data support the situation-specific theory of heart failure self-care with the addition of three new relationships that emerged from the analysis. Results of this study lend further support to the use of the situation-specific theory of heart failure self-care in research and practice.
authors.affiliation: School of Nursing, University Tor Vergata, Rome, Italy.
authors.forename: Ercole
authors.initials: E
authors.lastname: Vellone
authors.forename: Barbara
authors.initials: B
authors.lastname: Riegel
authors.forename: Fabio
authors.initials: F
authors.lastname: D'Agostino
authors.forename: Roberta
authors.initials: R
authors.lastname: Fida
authors.forename: Gennaro
authors.initials: G
authors.lastname: Rocco
authors.forename: Antonello
authors.initials: A
authors.lastname: Cocchieri
authors.forename: Rosaria
authors.initials: R
authors.lastname: Alvaro
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006333:Heart Failure / Q000517:prevention & control / Q000628:therapy*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D010349:Patient Compliance; D012648:Self Care; D011795:Surveys and Questionnaires
keywords: heart failure; nursing; self-care; structural equation modelling; symptom monitoring; symptom recognition and evaluation; theory testing; treatment adherence; treatment implementation