Predictors of Self-Care in Patients with Heart Failure

Monday, July 11, 2011

Hsing-Mei Chen, PhD, RN1
Chee-Siong Lee, MD2
Shuo-Tsan Lee, MD2
(1)School of Nursing, Kaohsiung Medical University, Kaohsiung City, Taiwan
(2)Devision of Cardiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

Learning Objective 1: understand self-care of patients with heart failure in Taiwan.

Learning Objective 2: understand the predictors of self-care in Taiwanese people with heart failure.


Self-care is fundamental to effective management of heart failure. However, patients with heart failure fail to engage in self-care activities. The purpose of this study was to investigate the predictors of self-care in Taiwanese people with heart failure.


 A cross-sectional, descriptive, correlational research design was used. A purposive sample of 118 participants was mainly recruited from the outpatient departments of three hospitals. Inclusion criteria were as follows: 1) a diagnosis of HF, including all classes of NYHA; 2) age 20 or older; 3) able to communicate either by speaking or writing Mandarin; and 4) willing to participate in this study. Instruments included demographic questionnaire, heart failure characteristics questionnaire, Mini Mental State Examination, Health Knowledge Questionnaire, Patient Outcome Questionnaire-9, and Self-Care of Heart Failure Index.


The mean self-care maintenance score was 67.34 (12.65), the mean self-care management score was 65.73 (18.46), and the mean self-care confidence was 80.57 (18.85). Hierarchical regression analyses with forward method were used to identify predictors of self-care variables. Two predictors of self-care maintenance were perceived financial status (R2 = 0.047) and health knowledge (R2 = 0.071). Living status (R2 = 0.062) was the only predictor of self-care management. The predictor of self-care confidence was body weight (R2 = 0.056). Depression, cognition, comorbidity, and heart failure severity, however, were not significant predictors for all self-care variables.


The scores for self-care maintenance and management were lower than the cut-off score of 70 set by the developer of Self-Care of Heart Failure Index.  Further intervention should be designed to help patients improve their self-care.