title: Patterns of Self-care in Adults With Heart Failure and Their Associations With Sociodemographic and Clinical Characteristics, Quality of Life, and Hospitalizations: A Cluster Analysis.
abstract: BACKGROUND
  Self-care is important in heart failure (HF) treatment, but patients may have difficulties and be inconsistent in its performance. Inconsistencies in self-care behaviors may mirror patterns of self-care in HF patients that are worth identifying to provide interventions tailored to patients.
  
  
  OBJECTIVE
  The aims of this study are to identify clusters of HF patients in relation to self-care behaviors and to examine and compare the profile of each HF patient cluster considering the patient's sociodemographics, clinical variables, quality of life, and hospitalizations.
  
  
  METHODS
  This was a secondary analysis of data from a cross-sectional study in which we enrolled 1192 HF patients across Italy. A cluster analysis was used to identify clusters of patients based on the European Heart Failure Self-care Behaviour Scale factor scores. Analysis of variance and χ test were used to examine the characteristics of each cluster.
  
  
  RESULTS
  Patients were 72.4 years old on average, and 58% were men. Four clusters of patients were identified: (1) high consistent adherence with high consulting behaviors, characterized by younger patients, with higher formal education and higher income, less clinically compromised, with the best physical and mental quality of life (QOL) and lowest hospitalization rates; (2) low consistent adherence with low consulting behaviors, characterized mainly by male patients, with lower formal education and lowest income, more clinically compromised, and worse mental QOL; (3) inconsistent adherence with low consulting behaviors, characterized by patients who were less likely to have a caregiver, with the longest illness duration, the highest number of prescribed medications, and the best mental QOL; (4) and inconsistent adherence with high consulting behaviors, characterized by patients who were mostly female, with lower formal education, worst cognitive impairment, worst physical and mental QOL, and higher hospitalization rates.
  
  
  CONCLUSIONS
  The 4 clusters identified in this study and their associated characteristics could be used to tailor interventions aimed at improving self-care behaviors in HF patients.
authors.affiliation: Ercole Vellone, PhD, RN Research Fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy. Roberta Fida, PhD Lecturer in organizational behavior, Norwich Business School, University of East Anglia, Norwich, UK. Valerio Ghezzi, PhD Department of Psychology, Sapienza University, Rome, Italy. Fabio D'Agostino, PhD, RN Research Fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy. Valentina Biagioli, MSN, RN PhD Student, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy. Marco Paturzo, MSN, RN PhD Student, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy. Anna Strömberg, PhD, RN Professor, Department of Medicine and Care and Department of Cardiology, University of Linköping, Sweden. Rosaria Alvaro, MSN, RN Associate Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy. Tiny Jaarsma, PhD, RN Professor, Department of Social and Welfare Studies, University of Linköping, Norrköping, Sweden.
authors.forename: Ercole
authors.initials: E
authors.lastname: Vellone
authors.forename: Roberta
authors.initials: R
authors.lastname: Fida
authors.forename: Valerio
authors.initials: V
authors.lastname: Ghezzi
authors.forename: Fabio
authors.initials: F
authors.lastname: D'Agostino
authors.forename: Valentina
authors.initials: V
authors.lastname: Biagioli
authors.forename: Marco
authors.initials: M
authors.lastname: Paturzo
authors.forename: Anna
authors.initials: A
authors.lastname: Strömberg
authors.forename: Rosaria
authors.initials: R
authors.lastname: Alvaro
authors.forename: Tiny
authors.initials: T
authors.lastname: Jaarsma
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006333:Heart Failure / Q000523:psychology* / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012648:Self Care; D012959:Socioeconomic Factors