Trajectories of heart failure self-care management and changes in quality of life

Christopher S. Lee, James O. Mudd, Shirin O. Hiatt, Jill M. Gelow, Christopher Chien, Barbara Riegel

Research output: Contribution to journalArticle

Abstract

Introduction: Heart failure patients vary considerably in their self-care management behaviors (i.e. recognizing and responding to symptoms). The goal of this study was to identify unique patterns of change in heart failure self-care management and quantify associations between self-care management and quality of life (HRQOL) over time. Methods: A prospective cohort study among adults with symptomatic heart failure was designed to measure changes in self-care management (Self-care of Heart Failure Index) and HRQOL (Kansas City Cardiomyopathy Questionnaire) over six months. Growth mixture modeling was used to identify unique trajectories of change in self-care management. Results: The mean age (n=146) was 57 years, 70% were male, and 41% had class II heart failure. Two trajectories of self-care management were identified (entropy = 0.88). The larger trajectory (73.3%) was characterized by a significant decline in self-care management over time and no change in HRQOL. The smaller trajectory (26.7%) was characterized by marked improvements in self-care management and HRQOL. Changes in heart failure self-care management occurred in the absence of change in routine self-care maintenance behaviors, functional classification, and physical and psychological symptoms. Patients with greater physical symptoms at enrollment (odds ratio (OR) =1.04, p=0.037), larger left ventricles (OR=1.50, p=0.044), and ischemic heart failure (OR=3.84, p=0.014) were more likely to have the declining trajectory of self-care management. Higher levels of depression at enrollment were associated with reduced odds of having a decline in self-care management over time (OR=0.85, p

Original languageEnglish (US)
Pages (from-to)486-494
Number of pages9
JournalEuropean Journal of Cardiovascular Nursing
Volume14
Issue number6
DOIs
StatePublished - Dec 1 2015
Externally publishedYes

Fingerprint

Self Care
Heart Failure
Quality of Life
Odds Ratio

Keywords

  • Heart failure
  • quality of life
  • self-care
  • symptom management

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing
  • Medical–Surgical

Cite this

Trajectories of heart failure self-care management and changes in quality of life. / Lee, Christopher S.; Mudd, James O.; Hiatt, Shirin O.; Gelow, Jill M.; Chien, Christopher; Riegel, Barbara.

In: European Journal of Cardiovascular Nursing, Vol. 14, No. 6, 01.12.2015, p. 486-494.

Research output: Contribution to journalArticle

Lee, Christopher S. ; Mudd, James O. ; Hiatt, Shirin O. ; Gelow, Jill M. ; Chien, Christopher ; Riegel, Barbara. / Trajectories of heart failure self-care management and changes in quality of life. In: European Journal of Cardiovascular Nursing. 2015 ; Vol. 14, No. 6. pp. 486-494.
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