Background: Comorbidity is associated with decreased confidence or self-efficacy to perform self-care in heart failure patients which, in turn, impairs self-care behaviors. Comorbidity is also associated with increased hospitalization rates and poorer quality of life. Yet the manner in which comorbidity and self-efficacy interact to influence self-care, hospitalization, and quality of life remains unclear. Objectives: The purpose of this study was to test an explanatory model. The research questions were (1) What is the contribution of comorbidity to heart failure self-care behaviors and outcomes (i.e. hospitalization, quality of life)? and (2) Is comorbidity a moderator of the relationship between self-efficacy and heart failure self-care behaviors? Design: This was an analysis of an existing dataset of 628 symptomatic, older (mean age = 73, standard deviation (SD) = 11) male (58%) Italian heart failure patients using structural equation modeling and simple slope analysis. Results: Higher levels of self-care maintenance were associated with higher quality of life and lower hospitalization rates. Higher levels of comorbidity were associated with lower levels of self-care management. Comorbidity moderated the relationship between selfefficacy and self-care maintenance, but not self-care management. Post hoc simple slopes analysis showed significantly different slope coefficients (pdiff < .05). Specifically, in patients with less comorbidity, the relationship between self-efficacy and self-care was significantly stronger than in patients with higher comorbidity. Conclusions: Self-efficacy is importantin the self-care maintenance process at each level of comorbidity. Because higher comorbidity weakens the strength of the relationship between self-efficacy and self-care maintenance, tailoring interventions aimed at improving self-efficacy to different levels of comorbidity may be key to impacting hospitalization and quality of life.

Predictors of hospitalization and quality of life in heart failure: a model of comorbidity, self-efficacy and self-care / Buck, Harleah G; Dickson, Victoria Vaughan; FIDA, Roberta; Riegel, Barbara; D'AGOSTINO, Fabio; Alvaro, Rosaria; VELLONE, ERCOLE. - In: INTERNATIONAL JOURNAL OF NURSING STUDIES. - ISSN 0020-7489. - STAMPA. - 52:11(2015), pp. 1714-1722. [10.1016/j.ijnurstu.2015.06.018]

Predictors of hospitalization and quality of life in heart failure: a model of comorbidity, self-efficacy and self-care

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

Abstract

Background: Comorbidity is associated with decreased confidence or self-efficacy to perform self-care in heart failure patients which, in turn, impairs self-care behaviors. Comorbidity is also associated with increased hospitalization rates and poorer quality of life. Yet the manner in which comorbidity and self-efficacy interact to influence self-care, hospitalization, and quality of life remains unclear. Objectives: The purpose of this study was to test an explanatory model. The research questions were (1) What is the contribution of comorbidity to heart failure self-care behaviors and outcomes (i.e. hospitalization, quality of life)? and (2) Is comorbidity a moderator of the relationship between self-efficacy and heart failure self-care behaviors? Design: This was an analysis of an existing dataset of 628 symptomatic, older (mean age = 73, standard deviation (SD) = 11) male (58%) Italian heart failure patients using structural equation modeling and simple slope analysis. Results: Higher levels of self-care maintenance were associated with higher quality of life and lower hospitalization rates. Higher levels of comorbidity were associated with lower levels of self-care management. Comorbidity moderated the relationship between selfefficacy and self-care maintenance, but not self-care management. Post hoc simple slopes analysis showed significantly different slope coefficients (pdiff < .05). Specifically, in patients with less comorbidity, the relationship between self-efficacy and self-care was significantly stronger than in patients with higher comorbidity. Conclusions: Self-efficacy is importantin the self-care maintenance process at each level of comorbidity. Because higher comorbidity weakens the strength of the relationship between self-efficacy and self-care maintenance, tailoring interventions aimed at improving self-efficacy to different levels of comorbidity may be key to impacting hospitalization and quality of life.
2015
comorbidity; explanatory model; heart failure; self-care; self-efficacy
01 Pubblicazione su rivista::01a Articolo in rivista
Predictors of hospitalization and quality of life in heart failure: a model of comorbidity, self-efficacy and self-care / Buck, Harleah G; Dickson, Victoria Vaughan; FIDA, Roberta; Riegel, Barbara; D'AGOSTINO, Fabio; Alvaro, Rosaria; VELLONE, ERCOLE. - In: INTERNATIONAL JOURNAL OF NURSING STUDIES. - ISSN 0020-7489. - STAMPA. - 52:11(2015), pp. 1714-1722. [10.1016/j.ijnurstu.2015.06.018]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/950249
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