title: Does improvement in self-management skills predict improvement in quality of life and depressive symptoms? A prospective study in patients with heart failure up to one year after self-management education.
abstract: Heart failure (HF) patient education aims to foster patients' self-management skills. These are assumed to bring about, in turn, improvements in distal outcomes such as quality of life. The purpose of this study was to test the hypothesis that change in self-reported self-management skills observed after participation in self-management education predicts changes in physical and mental quality of life and depressive symptoms up to one year thereafter.
  
  
  
  The sample comprised 342 patients with chronic heart failure, treated in inpatient rehabilitation clinics, who received a heart failure self-management education program. Latent change modelling was used to analyze relationships between both short-term (during inpatient rehabilitation) and intermediate-term (after six months) changes in self-reported self-management skills and both intermediate-term and long-term (after twelve months) changes in physical and mental quality of life and depressive symptoms.
  
  
  
  Short-term changes in self-reported self-management skills predicted intermediate-term changes in mental quality of life and long-term changes in physical quality of life. Intermediate-term changes in self-reported self-management skills predicted long-term changes in all outcomes.
  
  
  
  These findings support the assumption that improvements in self-management skills may foster improvements in distal outcomes.
authors.affiliation: Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Klinikstr. 3, D-97070, Würzburg, Germany. gunda.musekamp@uni-wuerzburg.de.
authors.forename: Gunda
authors.initials: G
authors.lastname: Musekamp
authors.affiliation: Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Klinikstr. 3, D-97070, Würzburg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Schuler
authors.affiliation: Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Klinikstr. 3, D-97070, Würzburg, Germany.
authors.forename: Bettina
authors.initials: B
authors.lastname: Seekatz
authors.affiliation: Institute of Psychology, Department of Rehabilitation Psychology and Psychotherapy, University of Freiburg, Engelbergerstraße 41, D-79085, Freiburg, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Bengel
authors.affiliation: Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Klinikstr. 3, D-97070, Würzburg, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Faller
authors.affiliation: Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Klinikstr. 3, D-97070, Würzburg, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Meng
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000072038:Cardiac Rehabilitation / Q000379:methods*; D002908:Chronic Disease; D003863:Depression / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D010353:Patient Education as Topic; D011446:Prospective Studies; D011788:Quality of Life; D012648:Self Care / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cardiac rehabilitation; Chronic heart failure; Latent change; Patient education; Quality of life; Self-management