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Event-free survival in adults with heart failure who engage in self-care management
Lee, C. Moser, Debra K. Lennie, Terry A. Riegel, Barbara
Lee, C.
Moser, Debra K.
Lennie, Terry A.
Riegel, Barbara
Abstract
Background Self-care management in heart failure (HF) involves decision-making to evaluate, and actions to ameliorate symptoms when they occur. This study sought to compare the risks of all-cause mortality, hospitalization, or emergency-room admission among HF patients who practice above-average self-care management, those who practice below-average self-care management, and those who are symptom-free. Methods A secondary analysis was conducted of data collected on 195 HF patients. A Cox proportional hazards model was used to examine the association between self-care management and event risk. Results The sample consisted of older (mean ± standard deviation = 61.3 ± 11 years), predominantly male (64.6%) adults, with an ejection fraction of 34.7% ± 15.3%; 60.1% fell within New York Heart Association class III or IV HF. During an average follow-up of 364 ± 288 days, 4 deaths, 82 hospitalizations, and 5 emergency-room visits occurred as first events. Controlling for 15 common confounders, those who engaged in above-average self-care management (hazard ratio, .44; 95% confidence interval, .22 to .88; P < .05) and those who were symptom-free (hazard ratio, 0.48; 95% confidence interval, .24 to .97; P < .05) ran a lower risk of an event during follow-up than those engaged in below-average self-care management. Conclusion Symptomatic HF patients who practice above-average self-care management have an event-free survival benefit similar to that of symptom-free HF patients.
Keywords
Heart failure, Self-care, Adherence, Self-management, Survival
Date
2011
Type
Journal article
Journal
Heart and Lung
Book
Volume
40
Issue
1
Page Range
12-20
Article Number
ACU Department
School of Allied Health
Faculty of Health Sciences
Mary MacKillop Institute for Health Research
Faculty of Health Sciences
Mary MacKillop Institute for Health Research
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled