title: The Association Between Mild Cognitive Impairment and Self-care in Adults With Chronic Heart Failure: A Systematic Review and Narrative Synthesis.
abstract: BACKGROUND
  Emerging evidence suggests that heart failure (HF) patients who have mild cognitive impairment (MCI) may experience greater difficulty with self-care.
  
  
  OBJECTIVE
  This article reports a systematic review that addressed the objective "What is the evidence for an association between MCI and self-care, measured in 1 or more of the self-care domains related to HF, in adults who have a diagnosis of chronic HF?"
  
  
  METHODS
  We adopted Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for the review and synthesis of quantitative research studies that formally measured both cognitive function and self-care in HF patients and sought to describe the relationship between these factors.
  
  
  RESULTS
  Ninety-one potentially relevant studies were located; 10 studies (2006-2014) were included. Because of heterogeneity in the retrieved studies, meta-analysis was not possible. Narrative synthesis found growing evidence regarding the association between MCI and adverse effects on self-care in HF. Nine studies reported significant positive associations between MCI and self-care in HF, either specifically in relation to medication adherence or more generic measures of self-care activity. One study reported a significant, negative correlation between cognitive function and self-care, suggesting that worse cognitive function was associated with better self-care; however, this is partially explained by a small sample size and mixed methodology.
  
  
  CONCLUSIONS
  These findings have implications for clinical practice. It is known that HF patients have difficulty with self-care, and the influence of cognitive function needs to be considered when providing professional support. Further research to determine the feasibility and acceptability of cognitive assessment in routine clinical care is recommended.
authors.affiliation: Kay Currie, PhD, RN Reader in Applied Health Research, Nursing & Community Health, Glasgow Caledonian University, Scotland, UK. Andrew Rideout, MPH, RN Researcher, Nursing & Community Health, Glasgow Caledonian University, Scotland, UK. Grace Lindsay, PhD, RN Reader in Nursing, Nursing & Community Health, Glasgow Caledonian University, Scotland, UK. Karen Harkness, PhD, RN Assistant Clinical Professor, School of Nursing, McMaster University, Ontario, Canada.
authors.forename: Kay
authors.initials: K
authors.lastname: Currie
authors.forename: Andrew
authors.initials: A
authors.lastname: Rideout
authors.forename: Grace
authors.initials: G
authors.lastname: Lindsay
authors.forename: Karen
authors.initials: K
authors.lastname: Harkness
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D060825:Cognitive Dysfunction / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006333:Heart Failure / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012648:Self Care