Heart failure beliefs and self-care adherence while being treated in an emergency department.
BACKGROUND
Heart failure (HF) emergency department (ED) visits are commonly due to HF self-care nonadherence.


OBJECTIVE
Our objective was to assess the accuracy of HF beliefs and adherence to self care in patients using an ED for acute HF.


METHODS
A cross-sectional, correlational study using validated surveys of HF beliefs and self-care adherence was conducted. A multivariable regression model was used to control for significant baseline factors.


RESULTS
In 195 adults, mean HF beliefs score was 2.8 ± 0.3, significantly below the accurate cutoff score of 3.0 (p < 0.001). Mean HF self-care adherence score was 5.1 (10 reflects best adherence). Of HF-related self-care behaviors, adherence was highest for taking medications without skipping or missing doses (7.8 ± 3.3) and lowest for daily weight monitoring (3.5 ± 3.5). Higher accuracy in HF beliefs was associated with higher education level (p = 0.01), younger age (p < 0.001), and choosing low-sodium restaurant foods (p = 0.04), but not with adherence to other self-care behaviors. Self-care adherence was associated with the belief that the HF care plan must be followed forever (p = 0.04), but not with other HF beliefs; and there was a trend toward lower HF self-care adherence when HF belief scores were more accurate. After controlling for significant baseline factors, HF beliefs were not associated with self-care adherence (p = 0.15).


CONCLUSIONS
Patients seeking ED care for decompensated HF had inaccurate HF beliefs and poor self-care adherence. Lack of association between HF beliefs and self care (and trend of an inverse relationship) reflects a need for predischarge HF education, including an explanation of what HF means and how it can be better controlled through self-care behaviors.
Nursing Institute and Kaufman Center for Heart Failure, Cleveland Clinic, Cleveland, Ohio.
Nancy M
NM
Albert
Emergency Medicine and Cardiovascular Research Institute, Wayne State University School of Medicine, Detroit, Michigan.
Phillip
P
Levy
Heart Failure Clinic, Morristown Medical Center, Morristown, New Jersey.
Elizabeth
E
Langlois
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio.
Benjamin
B
Nutter
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio.
Dongsheng
D
Yang
Emergency Medicine and Cardiovascular Research Institute, Wayne State University School of Medicine, Detroit, Michigan.
Vijaya Arun
VA
Kumar
Emergency Medicine and Cardiovascular Research Institute, Wayne State University School of Medicine, Detroit, Michigan.
Patrick
P
Medado
Emergency Department, Morristown Medical Center, Morristown, New Jersey.
Elizabeth
E
Nykun
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D003430:Cross-Sectional Studies; D004522:Educational Status; D004636:Emergency Service, Hospital; D015444:Exercise; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D012648:Self Care; D012982:Sodium, Dietary
D012982:Sodium, Dietary
adherence; emergency care; heart failure beliefs; self care; sodium in restaurant foods