Socio-clinical variables affecting the level of self-care in elderly patients with heart failure

Background: Promoting self-care is the cornerstone of heart failure management. The number of hospitalizations and unscheduled visits could be reduced in elderly patients with heart failure by the patients' active involvement in self-care. Aims: The aim of this study was to measure the level of self-care in elderly patients with heart failure, to examine the influence of socio-clinical variables on the level of self-care, and identify the socio-clinical variables that are predictors of self-care. Methods: The study included 100 heart failure patients (48 female, 52 male) aged between 60 and 88 years, treated at the Olesno Health Care Center (Poland). The European Heart Failure Self-care Behavior Scale-9 and Mini-Mental State Examination were used. Results: The total classic European Heart Failure Self-care Behavior Scale-9 score was 22.76 points (standard deviation=8.49), and the standardised European Heart Failure Self-care Behavior Scale-9 score was 61.78 (standard deviation=23.59). Patients who were in a relationship, did not take digoxin or diuretics, were in New York Heart Association classes I and II, and had normal scores or cognitive impairment in the Mini-Mental State Examination, had significantly higher levels of self-care. Self-care was also correlated with patient age (r(s)=-0.36, p<0.001) and left ventricle ejection fraction (r(s)=0.23, p=0.019). Linear regression analysis demonstrated that only the New York Heart Association class has a significant impact on European Heart Failure Self-care Behavior Scale-9 scores. Compared to classes I and II, New York Heart Association class IV decreases the standardised European Heart Failure Self-care Behavior Scale-9 score by a mean of 23.60 points. Conclusions: Intensified self-care education should be provided to patients living alone, taking digoxin and diuretics, suffering from moderate dementia, and classified in New York Heart Association class IV. These patients may require specific educational strategies to gain the knowledge required for effective self-care.