Objectives: This study aims to 1) examine the relationships among resilience, depression, and self-care in CHF patients, and 2) determine whether the relationship between resilience and self-care is moderated by severity of depressive symptoms.
Methods: 128 CHF inpatients and outpatients were recruited from Northern Taiwan hospitals. Participants’ resilience, depression, and self-care were assessed using Resilience Scale, Beck Depression Inventory-II, and Self-care of Heart Failure Index, respectively. The multiple regression models were conducted in SAS software version 9.2 to determine the main and synergic effect of resilience and depression on self-care. All models controlled for confounders (i.e. age, gender, marriage state, education, co-morbidities, Body Mass Index, and weekly exercise).
Results: After adjustment for confounders, resilience was positively and significantly associated with both self-care maintenance (p < 0.01) and self-care confidence (p < 0.01). Depression was negatively and significantly associated with self-care confidence (p = 0.02). Furthermore, depression moderated the relationship between resilience and self-care maintenance (b = 0.02; p < 0.05) but not between resilience and self-care confidence (b = -0.00; p = 0.24). Specifically, there is a stronger effect of resilience on self-care maintenance in CHF patients with low depression compared with those with high depression.
Conclusion: Resilience can improve self-care maintenance and self-care confidence in CHF patients. The positive effect of resilience on self-care maintenance also depends on severity of depressive symptoms. Interventions to improve self-care in CHF patients should consider both the effects of resilience and depression to enhance the effectivity.
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