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Self-care confidence may be the key: A cross-sectional study on the association between cognition and self-care behaviors in adults with heart failure
Vellone, Ercole Fida, Roberta D'Agostino, Fabio Mottola, Antonella Juarez-Vela, Raul Alvaro, Rosaria Riegel, Barbara
Vellone, Ercole
Fida, Roberta
D'Agostino, Fabio
Mottola, Antonella
Juarez-Vela, Raul
Alvaro, Rosaria
Riegel, Barbara
Abstract
Background Self-care, a key element of heart failure care, is challenging for patients with impaired cognition. Mechanisms through which cognitive impairment affects self-care are not currently well defined but evidence from other patient populations suggests that self-efficacy, or task-specific confidence, mediates the relationship between cognitive functioning and patient behaviors such as self-care. Objective The aim of this study was to test the mediating role of self-care confidence in the relationship between cognition and self-care behaviors. Design A secondary analysis of data from a cross-sectional study. Setting Outpatient heart failure clinics in 28 Italian provinces. Participants 628 Italian heart failure patients. Methods We used the Self-Care of Heart Failure Index v.6.2 to measure self-care maintenance, self-care management, and self-care confidence. Cognition was assessed with the Mini Mental State Examination. Structural equation modeling was used to analyze the data. Results Participants were 73 years old on average (SD = 11), mostly (58%) male and mostly (77%) in New York Heart Association functional classes II and III. The mediation model showed excellent fit (comparative fit index = 1.0; root mean square error of approximation = 0.02): Self-care confidence totally mediated the relationship between cognition and self-care maintenance and management. Conclusion Cognition affects self-care behaviors indirectly, through self-care confidence. Interventions aimed at improving self-care confidence may improve self-care, even in heart failure patients with impaired cognition.
Keywords
CognitionCross-sectional studies, Heart failure, Medication adherence, Mild cognitive impairment, Nursing theory, Self care, Self efficacy
Date
2015
Type
Journal article
Journal
International Journal of Nursing Studies
Book
Volume
52
Issue
11
Page Range
1705-1713
Article Number
ACU Department
Mary MacKillop Institute for Health Research
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled