title: Living Arrangements Modify the Relationship Between Depressive Symptoms and Self-care in Patients With Heart Failure.
abstract: BACKGROUND
  Depressive symptoms hinder heart failure patients' engagement in self-care. As social support helps improve self-care and decrease depressive symptoms, it is possible that social support buffers the negative impact of depressive symptoms on self-care.
  
  
  OBJECTIVE
  The purpose of this study is to examine the effect of living arrangements as an indicator of social support on the relationship between depressive symptoms and self-care in heart failure patients.
  
  
  METHODS
  Stable heart failure patients (N = 206) completed the Patient Health Questionnaire-9 to measure depressive symptoms. Self-care (maintenance, management, and confidence) was measured with the Self-Care of Heart Failure Index. Path analyses were used to examine associations among depressive symptoms and the self-care constructs by living arrangements.
  
  
  RESULTS
  Depressive symptoms had a direct effect on self-care maintenance and management (standardized β = -0.362 and -0.351, respectively), but not on self-care confidence in patients living alone. Depressive symptoms had no direct or indirect effect on any of the 3 self-care constructs in patients living with someone.
  
  
  CONCLUSIONS
  Depressive symptoms had negative effects on self-care in patients living alone, but were not related to self-care in patients living with someone. Our results suggest that negative effects of depressive symptoms on self-care are buffered by social support.
authors.affiliation: Kyoung Suk Lee, PhD, RN, MPH College of Nursing, Assistant Professor, College of Nursing, Chungnam National University, Dea Jeon, South Korea. Terry A. Lennie, PhD, RN, FAAN, FAHA Professor and Associate Dean, PhD Studies, College of Nursing, University of Kentucky, Lexington. Ju Young Yoon, PhD, RN Assistant Professor, School of Nursing, University of Wisconsin-Madison. Jia-Rong Wu, PhD Assistant Professor, School of Nursing, The University of North Carolina at Chapel Hill. Debra K. Moser, DNSc, RN, FAAN, FAHA Professor and Gill Endowed Chair of Nursing and Codirector, RICH Heart Program, College of Nursing, University of Kentucky, Lexington.
authors.forename: Kyoung Suk
authors.initials: KS
authors.lastname: Lee
authors.forename: Terry A
authors.initials: TA
authors.lastname: Lennie
authors.forename: Ju Young
authors.initials: JY
authors.lastname: Yoon
authors.forename: Jia-Rong
authors.initials: JR
authors.lastname: Wu
authors.forename: Debra K
authors.initials: DK
authors.lastname: Moser
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006333:Heart Failure / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D012648:Self Care / Q000523:psychology*; D012944:Social Support