Self-Care Practices of Primary Health Care Patients Diagnosed with Chronic Heart Failure: A Cross-Sectional Survey

Rosalia Santesmases-Masana, Luis González-de Paz, Elvira Hernández-Martínez-Esparza, Belchin Kostov, Maria Dolors Navarro-Rubio, Rosalia Santesmases-Masana, Luis González-de Paz, Elvira Hernández-Martínez-Esparza, Belchin Kostov, Maria Dolors Navarro-Rubio

Abstract

Chronic heart failure patients require self-care behaviors and active monitoring of signs and symptoms to prevent worsening. Most patients with this condition are attended in primary healthcare centers. This study aimed to evaluate the endorsement of and adherence to self-care behaviors in primary health care patients with chronic heart failure. We conducted a multicenter cross-sectional study. We randomly included chronic heart failure patients from 10 primary healthcare centers in the Barcelona metropolitan area (Spain). Patients completed the European Heart Failure Self-Care Behaviour Scale, a health literacy questionnaire. Differences between groups were studied using ANOVA tests. We included 318 patients with a mean age of 77.9 years, mild limitations in functional activity New York Heart Association scale (NYHA) II = 51.25%), and a low health literacy index of 79.6%. The endorsement of self-care behaviors was low in daily weighing (10.66%), contacting clinicians if the body weight increased (22.57%), and doing physical exercise regularly (35.58%). Patients with lower educational levels and a worse health literacy had a lower endorsement. The screening of individual self-care practices in heart failure patients might improve the clinician follow-up. We suggest that primary healthcare clinicians should routinely screen self-care behaviors to identify patients requiring a closer follow-up and to design and adapt rehabilitation programs to improve self-care.

Keywords: health literacy; heart failure; primary healthcare; self-care practices.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Item category curves (ICC) for the 12 items. All items showed disordered thresholds that suggested that the categories should be collapsed.
Figure 2
Figure 2
Map of items and persons. Each “X” represents 1 patient. Self-care and endorsement of items are measured in the same units. The “M’s” represents the mean level of self-care on the patients’ side and the endorsement location on the items’ side.

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