Paper
Friday, July 15, 2005
Self-Care Resources Needed by Women With Diastolic Heart Failure Predict Quality of Life
Linda Baas, PhD, CS-ACNP1, Susan Roll, BSN2, Ginger Conway, MSN, CNP2, and Lynne Wagoner, MD2. (1) College of Nursing, University of Cincinnati, Cincinnati, OH, USA, (2) Division of Cardiology, University of Cincinnati, Cincinnati, OH, USA
| Learning Objective #1: Identify self-care resources based on the Modeling and Role Modeling Paradigm (Erickson, Tomlin, & Swain, 1988) |
| Learning Objective #2: Discuss the role of self-care needs in predicting quality of life in women with diastolic heart failure |
Background: Diastolic dysfunction (DD) with preserved left ventricular ejection fraction is a problem that is increasingly recognized in older women as the cause of dyspnea and fatigue. Many also suffer from co-morbidities that decrease physical function. Also, older women are often widowed, unable to drive, and may have greater difficulty in maintaining social connections. These physical and social factors have the potential for threatening quality of life (QOL) and self care. Erickson et al. (1983) proposed a model of Self Care in which actions taken by an individual to maintain or regain health are based on internal and external resources perceived to be available and needed. What is not known is whether these self care factors affect QOL in older women with DD. Purpose: This study examines the relationship among internal (i.e. hope) and external (i.e. support) resources perceived to be available and needed and QOL. Methods: The SF-36 physical composite score (PCS) and mental composite score (MCS) were used to assess QOL. The Self Care Resource Inventory was used to measure: internal resources (IR) external resources (ER), internal needs (IN) and external needs (EN). Twenty three women, with DD were surveyed. Mean age was 63.5 years (sd=7.3, range 55-81). Results: Stepwise regressions were performed using all four predictors to first assess PCS then MCS. Only EN was significant in predicting QOL. EN predicted 34% of the variance in PCS and 28% of the variance in MCS. The relationships were negative so that the greater the needs, the lower the QOL. Results differed from previous work with persons with other forms of cardiac disease in which IR was the strongest predictor of all measures of physical and emotional QOL. Conclusions: It is important to include an assessment of external resources needed by older women with diastolic dysfunction when examining QOL.