TY - JOUR
T1 - Predictors of Self-care among Chinese Patients with Chronic Heart Failure
T2 - A Situation-Specific Theory-Guided Structural Equation Model Analysis
AU - Zhang, Zeyu
AU - Koirala, Binu
AU - Gong, Guilan
AU - Bai, Xue
AU - Mao, Jing
AU - Davidson, Patricia M.
N1 - Funding Information:
Funding acquisition: Xue Bai, Guilan Gong, and Jing Mao. This study was funded by the Fundamental Research Funds for the Central Universities, Huazhong University of Science and Technology (2017KFYXJJ043). The authors have no conflicts of interest to disclose. Correspondence Xue Bai, PhD, School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Rd, Wuhan, Hubei Province, China 430030 ([email protected]). DOI: 10.1097/JCN.0000000000000918
Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.
PY - 2023/5/1
Y1 - 2023/5/1
N2 - Background Self-care is important for improving the health outcomes of individuals with chronic heart failure (CHF). However, predictors of self-care behaviors remain unclear in Chinese society. Objective The aims of this study were to explore predictors of self-care in Chinese patients with CHF and clarify the complex relationships between predictors and self-care behaviors guided by the Situation-Specific Theory of Heart Failure Self-Care. Methods A cross-sectional study was conducted among individuals hospitalized with CHF in China. Person, problem, and environmental factors pertaining to self-care were collected by a questionnaire survey. Self-care was assessed by the Self-Care of Heart Failure Index version 6. Direct and indirect relationships between factors and self-care behaviors and the mediating role of self-care confidence were analyzed by the structural equation model. Results In total, 204 participants were involved in this study. The Situation-Specific Theory of Heart Failure Self-Care model demonstrated a good fit (root mean square error of approximation, 0.046; goodness of fit index, 0.966; normed fit index, 0.914; comparative fit index, 0.971). Inadequate self-care capabilities were common among Chinese patients with CHF. Person-related factors (female gender, higher monthly income and educational level), problem-related factors (severe New York Heart Association function class and better instrumental activities of daily living), and environmental factors (better social support and living in more developed areas) were significant predictors of better self-care behaviors (P <.05). These associations were partly or fully mediated by self-care confidence. Conclusion The Situation-Specific Theory of Heart Failure Self-Care can be used to guide research and practice in patients with CHF. Interventions and policies on promoting self-care in Chinese population living with CHF are encouraged, particularly for underserved populations.
AB - Background Self-care is important for improving the health outcomes of individuals with chronic heart failure (CHF). However, predictors of self-care behaviors remain unclear in Chinese society. Objective The aims of this study were to explore predictors of self-care in Chinese patients with CHF and clarify the complex relationships between predictors and self-care behaviors guided by the Situation-Specific Theory of Heart Failure Self-Care. Methods A cross-sectional study was conducted among individuals hospitalized with CHF in China. Person, problem, and environmental factors pertaining to self-care were collected by a questionnaire survey. Self-care was assessed by the Self-Care of Heart Failure Index version 6. Direct and indirect relationships between factors and self-care behaviors and the mediating role of self-care confidence were analyzed by the structural equation model. Results In total, 204 participants were involved in this study. The Situation-Specific Theory of Heart Failure Self-Care model demonstrated a good fit (root mean square error of approximation, 0.046; goodness of fit index, 0.966; normed fit index, 0.914; comparative fit index, 0.971). Inadequate self-care capabilities were common among Chinese patients with CHF. Person-related factors (female gender, higher monthly income and educational level), problem-related factors (severe New York Heart Association function class and better instrumental activities of daily living), and environmental factors (better social support and living in more developed areas) were significant predictors of better self-care behaviors (P <.05). These associations were partly or fully mediated by self-care confidence. Conclusion The Situation-Specific Theory of Heart Failure Self-Care can be used to guide research and practice in patients with CHF. Interventions and policies on promoting self-care in Chinese population living with CHF are encouraged, particularly for underserved populations.
KW - chronic heart failure
KW - self-care
KW - situation-specific theory
KW - structural equation model
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U2 - 10.1097/JCN.0000000000000918
DO - 10.1097/JCN.0000000000000918
M3 - Article
C2 - 37027136
AN - SCOPUS:85146244215
SN - 0889-4655
VL - 38
SP - E87-E97
JO - Journal of Cardiovascular Nursing
JF - Journal of Cardiovascular Nursing
IS - 3
ER -