Relationships between activation level, knowledge, self-efficacy, and self-management behavior in heart failure patients discharged from rural hospitals

Abstract

Non-adherence to self-management guidelines accounted for 50% of hospital readmissions in heart failure patients. Evidence showed that patient activation affects self-management behaviors in populations living with chronic conditions. The purpose of this study was to describe patient activation level and its relationship with knowledge, self-efficacy and self-management behaviors in heart failure patients discharged from rural hospitals. Our study populations were recruited from two hospitals in rural areas of Nebraska. We found that two-thirds of the participants reported low activation levels (e.g., taking no action to manage their heart failure condition). In addition, low patient activation levels were associated with inadequate heart failure knowledge (p=.005), low self-efficacy (p<.001) and low engagement in heart failure self-management behaviors (p<.001) after discharge from hospital.

Self-management and associated factors among patients with end-stage renal disease undergoing hemodialysis at health facilities in Addis Ababa, Ethiopia

“…Both knowledge and self-efficacy were also important predictors of self-management in this study. Previous studies have also shown that having knowledge 2,18-22 and self-efficacy 2,17,19,[22][23][24] are positively associated with self- management. This implies the need to develop strategies to improve knowledge and self-efficacy in order to enhance hemodialysis self-management.…”

“…A multitude of factors may affect the self-management of patients with ESRD undergoing hemodialysis. These may include sociodemographic factors such as age, sex, marital status, and educational status 2,7,15,16 and disease-related factors such as duration and frequency of hemodialysis and complications, 2,17 hemodialysis knowledge, 2,18-22 selfefficacy, 2,17,19,[22][23][24] psychological status (anxiety and depression), 2,[18][19][20]25,26 and social support. 2,18,26,27 However, little known about the self-management of patients with ESRD undergoing hemodialysis in Ethiopia.…”

Effects of a home-based activation intervention on self-management adherence and readmission in rural heart failure patients: the PATCH randomized controlled trial

“…The secondary outcomes were measured via questionnaire at baseline and 3 months to test the intervention mechanisms, including SM knowledge, self-efficacy for SM, patient activation, and SM strategies. Details about measures, instruments and their psychometric properties were reported in another publications [ 16 , 20 , 21 ].…”

Effect of the self-management education program on the quality of life in people with chronic heart failure: a randomized controlled trial

“…According to a systematic review, a self-management education program on self-efficacy, knowledge improvement regarding nutritional restrictions, health status, exercise, weight loss and proper education helps with peoples’ adherence to healthcare interventions and changes their health condition ( 19 ). This program can improve the QOL through reducing the mortality rate, length of hospital stay, severity of symptoms ( 20 ), treatment costs ( 21 ) and physical limitations ( 22 ). A few studies have been conducted on the effect of the self-management education program on the QOL in people with CHF ( 20 ).…”