Background: Self-care, a key element of heart failure care, is challenging for patients with impaired cognition. Mechanisms through which cognitive impairment affects self-care are not currently well defined but evidence from other patient populations suggests that selfefficacy, or task-specific confidence, mediates the relationship between cognitive functioning and patient behaviors such as self-care. Objective: The aim of this study was to test the mediating role of self-care confidence in the relationship between cognition and self-care behaviors. Design: A secondary analysis of data from a cross-sectional study. Setting: Outpatient heart failure clinics in 28 Italian provinces. Participants: 628 Italian heart failure patients. Methods: We used the Self-Care of Heart Failure Index v.6.2 to measure self-care maintenance, self-care management, and self-care confidence. Cognition was assessed with the Mini Mental State Examination. Structural equation modeling was used to analyze the data. Results: Participants were 73 years old on average (SD = 11), mostly (58%) male and mostly (77%) in New York Heart Association functional classes II and III. The mediation model showed excellent fit (comparative fit index = 1.0; root mean square error of approximation = 0.02): Self-care confidence totally mediated the relationship between cognition and self-care maintenance and management. Conclusion: Cognition affects self-care behaviors indirectly, through self-care confidence. Interventions aimed at improving self-care confidence may improve self-care, even in heart failure patients with impaired cognition.

Self-care confidence may be the key: a cross-sectional study on the association between cognition and self-care behaviors in adults with heart failure / Vellone, Ercole; Fida, Roberta; D'Agostino, Fabio; Mottola, Antonella; Juarez Vela, Raul; Alvaro, Rosaria; Riegel, Barbara. - In: INTERNATIONAL JOURNAL OF NURSING STUDIES. - ISSN 0020-7489. - STAMPA. - 52:11(2015), pp. 1705-1713. [10.1016/j.ijnurstu.2015.06.013]

Self-care confidence may be the key: a cross-sectional study on the association between cognition and self-care behaviors in adults with heart failure

VELLONE, ERCOLE
;
FIDA, Roberta;D'AGOSTINO, Fabio;
2015

Abstract

Background: Self-care, a key element of heart failure care, is challenging for patients with impaired cognition. Mechanisms through which cognitive impairment affects self-care are not currently well defined but evidence from other patient populations suggests that selfefficacy, or task-specific confidence, mediates the relationship between cognitive functioning and patient behaviors such as self-care. Objective: The aim of this study was to test the mediating role of self-care confidence in the relationship between cognition and self-care behaviors. Design: A secondary analysis of data from a cross-sectional study. Setting: Outpatient heart failure clinics in 28 Italian provinces. Participants: 628 Italian heart failure patients. Methods: We used the Self-Care of Heart Failure Index v.6.2 to measure self-care maintenance, self-care management, and self-care confidence. Cognition was assessed with the Mini Mental State Examination. Structural equation modeling was used to analyze the data. Results: Participants were 73 years old on average (SD = 11), mostly (58%) male and mostly (77%) in New York Heart Association functional classes II and III. The mediation model showed excellent fit (comparative fit index = 1.0; root mean square error of approximation = 0.02): Self-care confidence totally mediated the relationship between cognition and self-care maintenance and management. Conclusion: Cognition affects self-care behaviors indirectly, through self-care confidence. Interventions aimed at improving self-care confidence may improve self-care, even in heart failure patients with impaired cognition.
2015
cognition; cross-sectional studies; heart failure; medication adherence; mild cognitive impairment; nursing theory; self care; self efficacy
01 Pubblicazione su rivista::01a Articolo in rivista
Self-care confidence may be the key: a cross-sectional study on the association between cognition and self-care behaviors in adults with heart failure / Vellone, Ercole; Fida, Roberta; D'Agostino, Fabio; Mottola, Antonella; Juarez Vela, Raul; Alvaro, Rosaria; Riegel, Barbara. - In: INTERNATIONAL JOURNAL OF NURSING STUDIES. - ISSN 0020-7489. - STAMPA. - 52:11(2015), pp. 1705-1713. [10.1016/j.ijnurstu.2015.06.013]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/950248
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