Factors Associated with Heart Failure Knowledge and Adherence to Self-Care Behaviors in Hospitalized Patients with Acute Decompensated Heart Failure Based on Data from "the Weak Heart" Educational Program

Purpose: As insufficient adherence to recommendations is a major cause of poor health outcomes in patients with heart failure (HF), it is important to identify the factors that improve disease knowledge and self-care behaviors. We aimed to identify factors associated with HF knowledge and self-care behaviors in patients hospitalized due to acute decompensated heart failure (ADHF) in Poland. Patients and Methods: This was a secondary analysis of data from a multi-center, prospective, non-randomized educational program named "The Weak Heart", which was conducted in 14 cardiology centers in Poland. The level of HF knowledge was assessed using a questionnaire developed by the research team, and self-care behaviors were evaluated using the European Heart Failure Self-care Behaviour Scale (9-EHFScBS) questionnaire. Results: The study included 259 patients admitted to the hospital with ADHF. The mean HF knowledge and 9-EHFScBS questionnaire scores were 8.25 +/- 4.34 and 25.2 +/- 9.5, respectively. The patients' level of education (P = 0.002), number of prior HF hospitalizations (P = 0.008), and previous disease education (P < 0.001) were independently associated with better HF knowledge. Age (P = 0.03) and disease education (P = 0.02) were independently associated with self-care behaviors. Conclusion: The adherence to self-care recommendations among patients with ADHF is insufficient. Disease education positively influenced both HF knowledge and self-care abilities. To improve patients' adherence to HF recommendations, well-designed models of education based on HF management guidelines should be implemented.