Heart failure self-care, factors influencing self-care and the relationship with health-related quality of life: A cross-sectional observational study

Background: Self-care helps maintain health, prevents complications and improves the quality of life of patients living with heart failure (HF). Self-care is critical to HF management but has received limited attention in Nepal. Identification of the sociodemographic and clinical characteristics associated with self-care is crucial to tailoring appropriate self-care programs to improve health outcomes including patients' quality of life. Aims: The aims of this study were to describe self-care including the factors influencing self-care and the relationship between self-care and health-related quality of life in patients living with HF in Kathmandu, Nepal. Methods: We used a cross-sectional observational study design to measure self-care maintenance, self-care management, and self-care confidence using the Nepali Self-Care of Heart Failure Index. To analyze data, we used descriptive statistics, bivariate associations and regression modeling. Results: We recruited 221 patients with HF: mean age 57.5 +/- 15.76 years, 62% male. The results in this sample indicated poor self-care maintenance (38.5 +/- 11.56), management (45.7 +/- 15.14), and confidence (40.9 +/- 16.31). Patients with higher education were associated with higher self-care maintenance and management. Living alone and a better New York Heart Association functional classification for HF were related to higher self-care confidence. Higher social support was associated with better self-care. Self-care confidence was an independent predictor of self-care maintenance, management and health-related quality of life on adjusted analyses. Conclusion: Self-care was limited among patients living with HF in Nepal yet was associated with better quality of life. The study identified various sociodemographic and clinical factors related to self-care, which could be crucial while developing self-care interventions.