Self-Care Behaviours and Heart Failure: Does Experience with Symptoms Really Make a Difference?

Background: There are many reasons to explain why achievement of optimal self-care can be difficult for many patients with chronic heart failure (CHF).

Aim: To investigate differences in self-care skills between patients with and without experience of CHF symptoms.

Methods: On the basis of a confirmed diagnosis and treatment for CHF < 2 months or > 2 months, patients were prospectively designated as “novices” or “experienced”. Administration of the Self-Care Heart Failure Index assessed 3 self-care skills: maintenance, management and confidence. A score > 70% in each scale is considered adequate self care. Hierarchal regression models were built to test three hypotheses.

Results: In 143 elderly patients hospitalised with CHF, novices had lower self-care maintenance (63 ± 16 vs. 71 ± 14, p = 0.05) and self-care management scores (48 ± 17 vs. 58 ± 19, p = 0.003) than experienced patients. Novices were less likely to have adequate self-care maintenance (OR, 0.73; 95% CI 0.5 to 0.9, LR < 0.02) and management (OR, 0.3; 95% CI, 0.1 to 0.8, p = 0.02). Patients experienced with CHF had similar confidence levels (66 ± 17 vs. 64 ± 17, p = 0.40) to novices.

Conclusion: Level of experience is a determinant of self-care skills suggesting this factor should be considered in determining an individual education plan.